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QUESTION: In children with mild croup, does oral dexamethasone decrease the need for subsequent treatments and care and shorten symptom duration more than nebulised dexamethasone or placebo?
Design
Randomised (allocation concealed*), blinded {patients, clinicians, outcome assessors, and data collectors}†,* placebo controlled trial with 7 days of follow up.
Setting
Emergency departments at 2 large urban tertiary care centres in Ohio, USA.
Patients
264 children between 6 months and 6 years of age (mean age 28 mo, 68% boys) who had symptoms of croup for < 48 hours. Exclusion criteria were severe disease, receipt of racemic epinephrine or corticosteroid treatment, spasmodic croup, or a history of prolonged endotracheal intubation or chronic respiratory illness. 84% of patients were assessed at day 7.
Intervention
Children were allocated to oral dexamethasone, 0.6 mg/kg of …