The Comparison of Oral and IM Dexamethasone Efficacy in Croup Treatment

Soleimani, Gholamreza; Daryadel, Alireza; Moghadam, Alireza Ansari; Sharif, Mohammad Reza

doi:10.17795/compreped-4528

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…Soleimani et al, in a study to compare the effect of DM treatment of muscle by snapping on 68 children with croup, who were randomly divided into 2 groups, clinical symptoms, respiratory rate, heart rate, saturation of oxygen and response to treatment was measured. It was concluded that intramuscular and oral dexamethasone had same effect, but because of the non-invasiveness, oral route was used [12]. Most studies show the effectiveness of intramuscular dexamethasone in croup, but recent studies have shown that inhaled corticosteroids are also effective in the treatment for croup.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Cold Drink and Dexamethasone, and their Combined Effect on Children with Croup

2017

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Aims Croup is a clinical syndrome which included inspiratory stridor, coughing with a dog-like sound, noise obstruction and respiratory distress symptoms. This present study was conducted to compare the effects of cold drink and dexamethasone, and the effects of their co-administration on children’s croup. Materials and Methods In this study, all patients with croup admitted to the emergency ward of Madani Hospital Khorramabad were divided through the simple randomized method into 3 groups after informed consents were taken from their parents. The first group was given cold drink, second group with dexamethasone (DM), and the third group were given the combined treatment simultaneously. The patients in the first and second groups who did not show signs of improvement received the simultaneous treatment similar to the third group. The data were analyzed using the SPSS software through descriptive statistics and inferential statistics including multi-field variance analysis and co-variance analysis. Result The results of the study indicated a statistically significant between the 3 group in terms of improvement time-scale of croup clinical symptoms (P=0.001). There was no significant difference observed between the effects of other variables on improvement time-scale of croup clinical symptoms. Conclusion The cold drink has less treating effect than DM and combined simultaneous treatment method. Also, DM had more influence than simultaneous treatment method. In addition, other variables including age, sex, birth weight, BMI, respiratory allergy and previous croup history did not influenced improvement time-scale and only type of intervention influenced improvement time-scale of croup clinical symptoms.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Cold Drink and Dexamethasone, and their Combined Effect on Children with Croup

2017

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“…Across various levels of croup severity, all these methods, whether it was intramuscular, intravenous, oral, or inhaled, proved to be effective. Support for these findings also comes from a randomized controlled trial (RCT) performed in Iran [4,5]. In another study focusing on outpatient care, oral dexamethasone was compared with oral prednisolone in the treatment of 87 children with mild to moderate croup symptoms.…”

Section: Introductionmentioning

confidence: 98%

An Overview of the Effectiveness of Corticoids in Croup: A Systematic Literature Review

Garzon Mora,

Jaramillo,

Briones Andriuoli

et al. 2023

Cureus

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Croup, also known as laryngotracheobronchitis, frequently leads to blockages in the upper respiratory tract in young children, presenting symptoms, such as a raspy voice, a distinctive cough, and noisy breathing during inhalation. Despite being a condition that often resolves on its own, it puts considerable strain on healthcare resources due to regular doctor visits, emergency room usage, and occasional hospital stays. Research focused on larger populations suggests that only a small percentage of children with croup end up requiring hospital admission for their condition. In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we executed a meticulous systematic review by scouring databases, such as PubMed, Google Scholar, and the Cochrane Library. A total of 10 articles met our inclusion criteria and were selected for in-depth analysis. These scholarly works provided substantive insights into the pharmacological agents deployed in the treatment of croup. From a clinical standpoint, the management of croup is highly contingent on the patient's hemodynamic status. Our review discerned a pronounced preference for corticosteroids as the primary therapeutic intervention over other alternatives, which are largely relegated to second-line or emergency applications. Interestingly, we found negligible differences among the various corticosteroid treatment options in terms of statistical significance, underscoring their broad utility in ameliorating the condition. In addition to corticosteroids, our review also explored other therapeutic options, such as heliox, nebulized adrenaline, and even natural interventions, such as exposure to outdoor cold air. The efficacy of these treatments demonstrated variable results, reinforcing the notion that while they may be useful in specific circumstances, they are not universally applicable or as robustly effective as corticosteroids. Given the preponderance of evidence favoring corticosteroids, further research is warranted to solidify their status as the first-line treatment in different medical settings, be it inpatient hospitals, outpatient clinics, or even for home-based care. Such studies will not only add a layer of confidence in current medical practice but could also potentially optimize treatment protocols, contributing to improved patient outcomes. Therefore, advancing our understanding of the effectiveness of corticosteroids as the cornerstone of croup management remains an area of paramount scientific and clinical importance.

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“…The optimal type of corticosteroid, route of administration, and dose have remained unclear. Trials comparing parenteral, oral, and nebulized routes of steroid delivery in croup have demonstrated that intramuscular, intravenous, oral, and inhaled routes of administration of glucocorticoids are effective in croup of all levels of severity, including one randomized-controlled trial carried out in Iran 4 , 5 . For this reason, oral corticosteroids are the preferred route unless oral intake is not possible.…”

Section: Introductionmentioning

confidence: 99%

Comparison between single-dose oral prednisolone and oral dexamethasone in the treatment of croup: a randomized-controlled trial

Asif

Tayyab

Qazi

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Croup is a common respiratory illness in children, accounting for 15% of annual clinic and emergency department visits for pediatric respiratory tract infections. We aimed to compare single-dose oral prednisolone with single-dose oral dexamethasone in the treatment of croup in terms of mean change in the Westley Croup Score. Setting: Emergency Department of Children Hospital. Duration: Six months from December 2017 to June 2022. Design: Randomized-controlled trial. Subjects and methods: A total of 226 children with Westley Croup Score 2 or more were included in this study. Patients were randomized into two groups, 113 patients received a single dose of 0.15 mg/kg of oral dexamethasone, while 113 patients received a single dose of 1 mg/kg of oral prednisolone. Croup score and other clinical observations were repeated at 4 h and recorded in the questionnaire. Results: The average age of the patients was 2.88±1.17 years. There were 129 (57.1%) males and 97 (42.9%) females. At 4 h, a significant reduction in mean Westley Croup Score was observed in group dexamethasone as compared with group prednisolone (P=0.0005). Conclusions: Our trial demonstrated that oral dexamethasone at a dose of 0.15 mg/kg is effective in reducing the total croup score but there were no statistical differences in respiratory rate, pulse rate, and oxygen saturation between groups. Future studies are required to determine if these treatments differ in efficacy for severe croup and whether there is a role for multiple-dose corticosteroid therapy in some patients.

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The Comparison of Oral and IM Dexamethasone Efficacy in Croup Treatment

Cited by 8 publications

References 15 publications

Comparison of the Effect of Cold Drink and Dexamethasone, and their Combined Effect on Children with Croup

Comparison of the Effect of Cold Drink and Dexamethasone, and their Combined Effect on Children with Croup

An Overview of the Effectiveness of Corticoids in Croup: A Systematic Literature Review

Comparison between single-dose oral prednisolone and oral dexamethasone in the treatment of croup: a randomized-controlled trial

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