Steroids are not indicated in the management of croup; I still have the pre-PowerPoint slides that say so. I used them for my resident teaching sessions of 3 decades ago. Today’s slides (we need a better term for our electronically stored, digitized images that are projected directly as the need arises) herald the opposite, ie, steroids are the standard of care in the management of croup. Segal et al, in this issue of Pediatrics, documented an 86% decrease in the number of hospital admissions for treatment of croup in Ontario, Canada, between 1993 and 2002. This change coincided with the adoption of outpatient glucocorticoid therapy for croup. Therefore, the observations by Segal et al can be viewed as outcome data supporting the efficacy of glucocorticoid therapy for this disease. This prompts a brief review of the steroid odyssey in croup.

Perhaps the most notable early challenge of...

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