Epinephrine metered‐dose inhaler for pediatric croup

Abstract

Croup is a common childhood disease of young children caused by viral infections that trigger varying degrees of upper airway obstruction. While croup of all severity is effectively treated with systemic corticosteroids, 1 nebulized epinephrine provides rapid and safe reduction in respiratory distress that lasts for 1-2 h. 2The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised concerns about nebulization as an aerosol-generating medical procedure (AGMP), prompting a search for alternative delivery methods to provide effective epinephrine therapy in children with croup to minimize SARS-CoV-2 transmission. Primatene Mist is an epinephrine metered-dose inhaler (MDI) manufactured and available over the counter in the United States. 3