Therapy of Croup: a Comparison of Rectal and Parenteral Administration of Glucocorticoids

Overview

Authors present a comparative retrospective study designed to verify the efficacy of rectal prednisone andglucocorticoids administered parenterally in the therapy of croup. Two hundred fifty nine children, hospitalizedfor croup during the period 1998 and 1999, were enrolled to the study. They were randomly assigned into one ofthree treatment groups. Group 1: rectal prednisone (38 female, 116 male, age range 0.25 - 10.58 yrs, average age3.41 ± 2.1 yrs, dosage of prednisone 0.5 - 9.09 mg/kg, average dose 2.22 ± 1.36mg/kg). Group 2: intravenous/intramusculardexamethasone (4 female, 13 male, age range 0.33 - 12.25 yrs, average age 3.66 ± 2.28 yrs, dosage ofdexamethasone 0.03 - 0.57 mg/kg, average dose 0.29 ± 0.14 mg/kg). Group 3: intravenous/intramuscular hydrocortisone(23 female, 65 male, age range 0.42 - 9.92 yrs, average age 3.34 ± 2.22 yrs, dosage of hydrocortisone 2.32- 16.6 mg/kg, average dose 7.05 ± 2.79 mg/kg). The clinical evaluation was based on the scoring system by Downes(first value on admission without glucocorticoids, second value during 6th hour after start of therapy withglucocorticoids).Authors conclude that intravenous/intramuscular dexamethasone and hydrocortisone aremore beneficial thanrectal prednisone. Authors found statistically significant improvement in the group of children treated withhydrocortisone when compared with the group treated with rectal prednisone.

Key words:
croup, glucocorticoids therapy, childhood