ORAL DEXAMETHASONE IN THE TREATMENT OF CROUP - 0.15 MG KG VERSUS 0.3 MG/KG VERSUS 0.6 MG/KG/

The objective of this study was to compare the efficacy of a single do se of oral dexamethasone of varying sizes in 120 children hospitalized with croup in two sequential double blind, randomized, controlled cli nical trials (Trials A and B). The study was conducted in the Emergenc y Department Observation Ward of a tertiary pediatric hospital. One hu ndred and twenty children (age range 6 to 160 months) hospitalized wit h croup participated. Baseline characteristics for the two groups in e ach trial were similar. In Trial A 60 children received either 0.6 or 0.3 mg/kg dexamethasone syrup; in Trial B 60 children received either 0.3 or 0.15 mg/kg dexamethasone syrup. Duration of hospitalization, re duction in croup scores, and adrenaline usage were evaluated. Median d uration of hospitalization was similar for children in Trial A (7 and 8 hr), and in Trial B (9 and 9 hr). Group scores following treatment d id not differ and were significantly lower than initial scores for all groups and in each trial. Other outcome measures were similar for the two groups in each trial, including need for nebulized adrenaline num bers of patients admitted to intensive care, rate of return to medical care with reoccurrence of croup, and readmission to hospital with cro up following discharge from hospital. We conclude that oral dexamethas one in a dose of 0.15 mg/kg is as effective as 0.3 or 0.6 mg/kg in rel ieving symptoms and results in a similar duration of hospitalization i n children with croup. (C) 1995 Wiley-Liss, Inc.