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An article entitled "Outpatient treatment of croup with nebulized
dexamethasone" by DW Johnson, S Schuh, G koren, and DM Jaffe was published
in Archives of Pediatric and Adolescent Medicine 150:349-55, 1996 Apr.
This was a randomized double-blind placebo-controlled trial where they
treated children with moderate croup with nebulized dexamethasone in doses
of >1 mg/kg. They found an improvement in clinical croup scores at 4
hours, but no reduction in hospitalization. Also, two neutropenic patients
developed bacterial tracheitis. They conclude that the use of nebulized
dexamethasone is not recommended.
There are two other published studies regarding nebulized budesonide - a
steroid which is available in some countries, but not in the U.S., and
which may be a more potent glucocorticoid - which suggest a benefit:
1) Nebulized budesonide for children with mild-to-moderate croup. TP
Klassen, ME Feldman, LK Watters, T Sutcliffe, PC Rowe. NEJM.
1994;331:285-9.
2) Treatment of croup with nebulized steroid (budesonide): a double blind,
placebo controlled study. S Husby, L Agertoft, S Mortensen, S Pedersen.
Arch Dis Child 1993;68:352-5.
 
Enjoy the reading!
 
On Wed, 4 Jun 1997, KEVIN ROMA wrote:
 
>      Recently had a child who presented with classic croup symptomology
> score of 4-5 .Started child on mist and B agonist and added to the regimen
> nebulized Dexamethasone .1 mg/kg Child did extremely well.This
> treatment was mentioned in Clinical Practice of EMERGENCY MEDICINE
> (ANN HARWOOD _NUSS) Does any one know of a study using this treatment?My
> lit search was uneventful.Any practicioners with personal experince using
> this treatment?
>
> For more information, send mail to [log in to unmask] with the message:
>  info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>   http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
>
 
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html