Budesonide offers no advantage when added to oral dexamethasone in the treatment of croup.
OBJECTIVE
To evaluate the effect of adding inhaled budesonide (2 mg) to oral dexamethasone 0.15 mg/kg in children hospitalized with croup.


METHODS
Observation ward of a Tertiary Paediatric Hospital Emergency Department.


METHODS
Seventy-two children (age range 3 to 126 months) hospitalized with croup.


METHODS
Children randomized to receive either 2 mg of nebulized budesonide or placebo, with all children receiving a single oral dose of 0.15 mg/kg dexamethasone.


METHODS
Primary outcome was duration of hospital stay. Other measures included croup scores from 0 to 12 hours, use of nebulized epinephrine, duration of croup symptoms, duration of viral symptoms, and return to medical care for croup or for any other reason following discharge from hospital.


RESULTS
Baseline characteristics for the 2 groups were similar. There was no difference in time to discharge for the 2 groups or for other outcome measures with a risk ratio of 1.3 (95% confidence intervals of 0.82 and 2.1).


CONCLUSIONS
The addition of inhaled budesonide (2 mg) to oral dexamethasone (0.15 mg/kg) offers no advantage in the treatment of children hospitalized with croup.
Geelhoed
Gary Cornelis
GC
Emergency Department, Princess Margaret Hospital for Children, Perth, WA, Australia. Gary.Geelhoed@health.wa.gov.au
D000280:Administration, Inhalation; D000284:Administration, Oral; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003440:Croup / Q000188:drug therapy*; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D010359:Patient Readmission; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D005938:Glucocorticoids; D019819:Budesonide; D003907:Dexamethasone