TY - JOUR
T1 - Nebulized budesonide and oral dexamethasone for treatment of croup
T2 - A randomized controlled trial
AU - Klassen, Terry P.
AU - Craig, William R.
AU - Moher, David
AU - Osmond, Martin H.
AU - Pasterkamp, Hans
AU - Sutcliffe, Terry
AU - Watters, Lise K.
AU - Rowe, Peter C.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1998/5/27
Y1 - 1998/5/27
N2 - Context. - The effectiveness of glucocorticoids for patients with croup is well established but it remains uncertain which glucocorticoid regimen is most effective. Objective. - To determine the effectiveness of 3 glucocorticoid regimens in patients with croup. Design. - Randomized controlled trial with parallel design. Setting. - Emergency departments of 2 Canadian pediatric tertiary care hospitals. Participants. - Children with a clinical syndrome consistent with croup, aged 3 months to 5 years, with a croup score of 2 or greater following at least 15 minutes of mist therapy. Interventions. - Oral dexamethasone, 0.6 mg/kg, and nebulized placebo; oral placebo and nebulized budesonide, 2 mg; or oral dexamethasone, 0.6 mg/kg, and nebulized budesonide, 2 mg. Main Outcome Measures. - Westley croup score (primary outcome), hospital admission rates, time spent in the emergency department, return visits to the emergency department, or ongoing symptoms at 1 week. Results. - The mean change in the croup score from baseline to the final study assessment was -2.3 (95% confidence interval [Cl], -2.6 to-2.0) in the budesonide group (n = 65), -2.4 (95% Cl, -2.6 to -2.2) in the dexamethasone group (n = 69), and -2.4 (95% Cl, -2.7 to -2.1) in the budesonide and dexamethasone group (n = 64, P = .70). Conclusions. - Based on the similar outcomes in the 3 groups, oral dexamethasone is the preferred intervention because of its ease of administration, lower cost, and more widespread availability.
AB - Context. - The effectiveness of glucocorticoids for patients with croup is well established but it remains uncertain which glucocorticoid regimen is most effective. Objective. - To determine the effectiveness of 3 glucocorticoid regimens in patients with croup. Design. - Randomized controlled trial with parallel design. Setting. - Emergency departments of 2 Canadian pediatric tertiary care hospitals. Participants. - Children with a clinical syndrome consistent with croup, aged 3 months to 5 years, with a croup score of 2 or greater following at least 15 minutes of mist therapy. Interventions. - Oral dexamethasone, 0.6 mg/kg, and nebulized placebo; oral placebo and nebulized budesonide, 2 mg; or oral dexamethasone, 0.6 mg/kg, and nebulized budesonide, 2 mg. Main Outcome Measures. - Westley croup score (primary outcome), hospital admission rates, time spent in the emergency department, return visits to the emergency department, or ongoing symptoms at 1 week. Results. - The mean change in the croup score from baseline to the final study assessment was -2.3 (95% confidence interval [Cl], -2.6 to-2.0) in the budesonide group (n = 65), -2.4 (95% Cl, -2.6 to -2.2) in the dexamethasone group (n = 69), and -2.4 (95% Cl, -2.7 to -2.1) in the budesonide and dexamethasone group (n = 64, P = .70). Conclusions. - Based on the similar outcomes in the 3 groups, oral dexamethasone is the preferred intervention because of its ease of administration, lower cost, and more widespread availability.
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U2 - 10.1001/jama.279.20.1629
DO - 10.1001/jama.279.20.1629
M3 - Article
C2 - 9613912
AN - SCOPUS:0032572078
SN - 0098-7484
VL - 279
SP - 1629
EP - 1632
JO - JAMA
JF - JAMA
IS - 20
ER -