Viral Croup - Alternatives to Treatment

It is now well accepted that early treatment with steroid does reduce the severity and length of symptoms with regard to viral croup. We have, in the past, used assorted doses of intramuscular Dexamethasone (.2 mg/kg. q8h for three doses or 0.6 mg/kg as one IM dose). More recently it has been recognized that a dose of 2 mg of Budeside by inhalation has similar effects. There is now information in the literature which appears to find similar benefits from oral Dexamethasone given in a dose of 0.15, 0.3, 0.6 mg/kg. A recent Australian study showed that these three doses seemed to have equivalent effects and the smaller dose of 0.15 mg/kg was as effective as the bigger doses.

It would be, now, quite possible to treat children with oral Dexamethasone and an inhalation as they come into the Emergency Room and then observe them for a few hours before you send them of. To be safe I would probably use the middle dose of 0.3mg/kg until we have further reports in the literature.

- Minoli Amit

This page last updated March 14, 1997