Why We Give Dexamethasone for Mild Croup

June 10, 2017

On the Shoulders of Giants

Take a bite out of the bark
In this double-blinded RCT, a total of 700 patients with mild croup (no stridor at rest) received either 0.6mg/kg of dexamethasone orally vs. placebo and had fewer return visits to a medical provider (determined by phone interview) in the next 7 days (7.3% vs 15.3%, NNT = 12.5).  They also found children slept better and healthcare costs were reduced.  There were no serious adverse effects in the dexamethasone group.

Spoon Feed
Dexamethasone is beneficial for mild croup, not just moderate to severe.

Source
A randomized trial of a single dose of oral dexamethasone for mild croup.  N Engl J Med. 2004 Sep 23;351(13):1306-13.