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Oral dexamethasone led to fewer treatment failures than did nebulised dexamethasone or placebo in children with mild croup

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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?


Randomised (allocation concealed*), blinded {patients, clinicians, outcome assessors, and data collectors},* placebo controlled trial with 7 days of follow up.


Emergency departments at 2 large urban tertiary care centres in Ohio, USA.


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.


Children were allocated to oral dexamethasone, 0.6 mg/kg of …

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  • Source of funding: Bremer Foundation at Ohio State University.

  • For correspondence: Dr J Luria, Children’s Hospital Medical Center, Cincinnati, Ohio, USA. joe.luria{at}

  • * See glossary.

  • Information provided by author.