Croup: are patients safe to discharge following nebulised adrenaline? Is ‘rebound phenomenon’ a myth?

Author: Dr Gareth Norton

Date: August 2022


Croup, or laryngotracheobronchitis, is an extremely common presentation of respiratory
disease in the paediatric population. The mainstay of treatment is oral corticosteroids and in moderate/severe cases nebulised adrenaline. Concerns exist around the possibility of a rebound effect where their are increased symptoms when the effect of a drug has passed. If a drug produces a rebound effect, the condition it was used to treat may return with an
increased severity. Or is there no rebound effect and the return of symptoms, even at an
increased severity is due to the natural course and progression of the treated condition?