Croup
- Illness of children younger than 6 years of age with peak incidence at 7-36 months.
- Systemic/nebulized corticosteroids have been proven to lessen severity and duration of symptoms, and hospitalization.
- Nebulized epinephrine is indicated in severe respiratory distress.
- Give blow-by oxygen if hypoxia (O2 sat < 92% on room air).
- Antitussives and decongestants not indicated. Sedation contraindicated.
Usual Pathogens
Viruses
No antibiotic therapy recommended
| Empiric Therapy | Duration | |
|---|---|---|
| Dexamethasone | 0.6mg/kg PO/IM/IV | Once. May repeat dose in 24h if symptoms recur |
| or | ||
| Budesonide | 2mg in 4mL sterile water via nebulizer | Once. May repeat dose in 24h if symptoms recur |
Severe
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Racemic epinephrine 2.25% | 0.5mL in 3mL NS or sterile water via nebulizer | Repeat as necessary |
| or | ||
| L-epinephrine | 1:1,000 solution - 5mL via nebulizer | Repeat as necessary |