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. 1999 Oct;171(4):227–232.

The effectiveness of glucocorticoids in treating croup: meta-analysis

Monica Ausejo 1,2,3, Antonio Saenz 1,2,3, Ba' Pham 1,2,3, David Moher 1,2,3, Thomas C Chalmers 1,2,3, James D Kellner 1,2,3, David W Johnson 1,2,3, Terry P Klassen 1,2,3
PMCID: PMC1305853  PMID: 18751187

Abstract

•Objective

To determine the effectiveness of glucocorticoid treatment in children with croup.

•Design

Meta-analysis of randomized controlled trials that examine the effectiveness of glucocorticoid treatment in children with croup.

•Main outcome measures

Score on scale measuring severity of croup,use of co-interventions (epinephrine, antibiotics, or supplemental glucocorticoids), length of stay in the emergency department or the hospital, and rate of hospitalization.

•Results

Twenty-four studies met the inclusion criteria. Glucocorticoid treatment was associated with an improvement in the croup severity score at 6 hours with an effect size of -1.0 (95% confidence interval [CI] -1.5 to -0.6) and at 12 hours -1.0 (-1.6 to -0.4); at 24 hours, this improvement was no longer significant (-1.0, -2.0 to -0.1). There was a decrease in the number of epinephrine treatments needed in children treated with glucocorticoids: a decrease of 9% (95% CI 2% to 16%) among those treated with budesonide and of 12% (4% to 20%) among those treated with dexamethasone. There was also a decrease in the length of time spent in the emergency department (-11 hours, 95% CI -18 to 4 hours) and, for inpatients, hospital stay was reduced by 16 hours (-31 to 1 hour). Publication bias seems to play a part in these results.

•Conclusions

Dexamethasone and budesonide are effective in relieving the symptoms of croup as early as 6 hours after treatment. Fewer co-interventions are used, and the length of time spent in the hospital is decreased in patients treated withglucocorticoids.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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