What is the role of corticosteroids in the treatment of croup?

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Corticosteroids are beneficial due to their anti-inflammatory action. Their use decreases both laryngeal mucosal edema and the need for salvage nebulized epinephrine. Corticosteroids may be warranted even for those children who present with mild symptoms. Treatment of croup with corticosteroids has not shown significant adverse effects; however despite the low risk, their use should be carefully evaluated for children with diabetes, an underlying immunocompromised state, or those recently exposed to or diagnosed with varicella or tuberculosis, due to the potential risk of exacerbating the co-current disease process. [27, 28, 29, 30, 31, 32] An updated 2018 Cochrane Review reported that glucocorticoids (ie, prednisone, dexamethasone) reduced symptoms of croup at 2 hours, shortened hospital stays, and reduced the rate of return visits for patient care. This conclusive report has changed, as the previous version of Cochrane Review reported that glucocorticoids reduced symptoms of croup within 6 hours post administration. [33]

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