5. Dexamethasone compared to prednisolone for croup.
| Dexamethasone compared to prednisolone for croup | |||||
| Patient or population: children with croup Intervention: dexamethasone Comparison: prednisolone | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | |
| Prednisolone | Dexamethasone | ||||
| Change in croup score. Assessed with the Westley croup score. Lower scores mean fewer symptoms. (follow‐up: 6 hours) | The mean change in croup score from 1 study was ‐2.35. | The mean change in croup score was 0.19 units less (0.17 more to 0.55 less). | ‐ | 99 (1 RCT) | ⊕⊕⊝⊝ LOWa, b |
| Return visits or (re)admissions or both | Study population | RR 0.39 (0.19 to 0.79) | 306 (3 RCTs) | ⊕⊕⊕⊝ MODERATEc | |
| 200 per 1000 | 78 per 1000 (38 to 158) | ||||
| Adverse events | Fifoot 2007, Garbutt 2013, and Sparrow 2006 reported no serious adverse events related to the glucocorticoids. | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | |||||
aWe downgraded by one level for inconsistency. As there was only one study in the analysis, there was no evidence of consistency. bWe downgraded by one level for imprecision. The sample size was small (did not meet the optimal information size). cWe downgraded by one level for imprecision. The sample size was small (did not meet the optimal information size).