Abstract | OBJECTIVE: METHODS: Children aged 6 months to 6 years presenting to a tertiary care pediatric emergency department (ED) with a modified Westley croup score of 0 to 11 were randomized to receive either 0.6 mg/kg IM dexamethasone or 0.4 mg/kg PO betamethasone. Croup score, heart rate, respiratory rate, pulse oximetry, and need for supplemental treatments were recorded at study entry and at 1, 2, and 4 hours after treatment. Follow-up data were collected by daily telephone follow-up on persistence of symptoms and the need for additional treatment or physician visits up to 7 days after the ED visit. RESULTS: Each study group contained 26 patients. Despite randomization, the mean baseline croup score was higher in the dexamethasone group (3.6 +/- 2.6 vs. 2.0 +/- 2.4, P = 0.03). Patients in both groups showed a significant reduction in the croup score after treatment, and there were no significant differences between croup scores at 4 hours (P = 0.18). Similarly, there were no differences between groups in the hospital admission rate, time to resolution of symptoms, need for additional treatments, or number of return ED visits. CONCLUSION: There is no difference between oral betamethasone and intramuscular dexamethasonein the management of mild to moderate viral croup. It is palatable and does not require a nurse for administration, making it a good alternative for ambulatory management.
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Authors | Lisa Amir, Henry Hubermann, Ayelet Halevi, Meirav Mor, Marc Mimouni, Yehezkel Waisman |
Journal | Pediatric emergency care
(Pediatr Emerg Care)
Vol. 22
Issue 8
Pg. 541-4
(Aug 2006)
ISSN: 1535-1815 [Electronic] United States |
PMID | 16912619
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Glucocorticoids
- Dexamethasone
- Betamethasone
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Topics |
- Administration, Oral
- Betamethasone
(administration & dosage)
- Child
- Child, Preschool
- Croup
(drug therapy, virology)
- Dexamethasone
(administration & dosage)
- Emergency Treatment
- Female
- Glucocorticoids
(administration & dosage)
- Humans
- Infant
- Injections, Intramuscular
- Male
- Prospective Studies
- Severity of Illness Index
- Time Factors
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