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J Fam Pract. 2011 Nov;60(11):680-1.

Clinical inquiries. What's best for croup?

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  • 1Swedish Family Medicine Residency-First Hill, Seattle, WA, USA.


A single dose of corticosteroids is the first-line treatment for croup, resulting in fewer return visits and hospital admissions, shorter lengths of stay in the emergency department (ED) or hospital, and less need for supplemental medication (strength of recommendation [SOR]: A, meta-analysis and randomized controlled trials [RCTs]). A 0.15 mg/kg dose of oral dexamethasone is as effective as larger doses (SOR: B, small RCTs).Nebulized racemic or L-epinephrine reduces severity of symptoms in moderate-to-severe croup (SOR: C, limited-quality disease-oriented evidence).The role of heliox in moderate to severe croup remains uncertain. Studies to date have been inadequate (SOR: C, limited-quality disease-oriented evidence).Humidified air provides no demonstrable benefit in the acute setting (SOR: A, meta-analysis).

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