Most clinicians use dexamethasone 0.6 mg/kg per dose to treat croup in the office or emergency department setting. But recently other steroid alternatives have been suggested, including low dose dexamethasone (0.15 mg/kg/dose) and prednisolone (1 mg/kg/dose). Drs. Colin Parker and Matthew Cooper (10.1542/peds.2018-3772) report a prospective double-blind randomized controlled trial being early released in our journal this week. The authors randomized children over 6 months of age and up to 20 kg in two emergency departments in Perth, Western Australia who had not been on steroids recently or had a potential for an illness other than croup. 1,252 children were enrolled to receive regular dexamethasone, low-dose dexamethasone, or prednisolone at doses noted above with the primary outcomes being an improved croup score one hour after treatment or return to the emergency department during the week post-treatment. So, what happened? Which steroid was the best in terms of the outcomes studied? Suffice it to say non-inferiority was demonstrated—meaning they all worked similarly in bringing down the croup score and resulting in fewer return visits. There is far more to learn however from reading this study which coughs up a myriad of interesting results besides the non-inferiority findings for low-dose dexamethasone and prednisolone compared to regular-dosed dexamethasone. So do you agree, or have you found one regimen to be more effective than another? We’d be interested in hearing your thoughts about treatment of croup by responding to this blog, sharing a comment on our website in conjunction with the article, or posting your thoughts on our Facebook or Twitter pages.
Skip Nav Destination
Making Some Noise About Prednisolone Versus Dexamethasone for Croup
:
Making Some Noise About Prednisolone Versus Dexamethasone for Croup
:
August 16, 2019
PDF Icon
PDF LinkDownload PDF
Content License:FreeView
Article type:
Pediatrics Blog