Outpatient management of croup

Terry P. Klassen, Peter C. Rowe

Research output: Contribution to journalReview articlepeer-review

Abstract

Now that there is widespread acceptance of glucocorticoids for inpatient treatment of croup, the focus of research has shifted to the effectiveness of glucocorticoids for outpatients with croup. Recent evidence from randomized controlled trials has shown that nebulized budesonide causes an acute improvement in croup symptoms, shortens stay in the emergency department, and significantly reduces admission rate. Intramuscular or oral dexamethasone also result in acute clinical improvement in patients with croup, and oral dexamethasone reduces the length of stay in an emergency department observation unit. There is accumulating evidence that patients receiving epinephrine do not necessarily require hospitalization but when treated simultaneously with dexamethasone may be safely discharged to home after a 3- hour observation period. Future trials in outpatients with croup need to determine the optimal dosing of oral dexamethasone, the utility of epinephrine therapy alone or in combination with glucocorticoids, and the optimal glucocorticoid regimen (budesonide, dexamethasone, or budesonide and dexamethasone).

Original languageEnglish (US)
Pages (from-to)449-452
Number of pages4
JournalCurrent opinion in pediatrics
Volume8
Issue number5
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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