Level 1: Likely reliable evidence

The efficacy of two different corticosteroid treatments for croup was evaluated in a randomized trial of 133 children aged 3-142 months with mild-to-moderate croup in a pediatric emergency department (ED) (Arch Dis Child. 2006;91:580-583). Participants were randomized to a single oral dose of dexamethasone 0.15 mg/kg vs. prednisolone 1 mg/kg.

Dexamethasone was associated with decreased re-attendance for medical care within 7-10 days (7.4% vs. 29.2%, NNT 5). Comparing dexamethasone vs. prednisolone, there were no significant differences in rates of hospital admissions (4.4% vs. 3.1%), mean time spent in the ED (114 vs. 84 minutes), or mean duration of croup symptoms (26 vs. 35 hours).

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