Viral Croup: A Current Perspective

Alexander K.C. Leung, MBBS, FRCPC, FRCP (UK & Irel), FRCPCH; James D. Kellner, MD, FRCPC; David W. Johnson, MD, FRCPC


J Pediatr Health Care. 2004;18(6) 

In This Article


We advocate that all children diagnosed with croup be treated with corticosteroids. Most children can be treated by health care practitioners with a single, oral dose of dexamethasone on an outpatient basis. Those with moderate involvement may need to be assessed in an emergency department. For those who do not tolerate the oral preparation, nebulized budesonide or intramuscular dexa-methasone are reasonable alternatives. Nebulized epinephrine should be reserved for patients with moderate to severe croup. Patients should be observed for a minimum of 2 hours after treatment with epinephrine. Simultaneous administration of corticosteroid with epinephrine reduces both the rate of hospitalization and intubation in patients with severe croup and impending respiratory failure.


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