CROUP
Author: Dr Alexander Stapleton
Type: MLP-case study
Date: 2022
ABSTRACT
Background: This literature review was devised to clarify the rationale between the use of
Dexamethasone and Prednisolone for the treatment of paediatric Croup in the community setting.
Methods: A computerised literature search of local and international Guidelines, PubMed and CENTRAL
(Cochrane Central Register of Controlled Trials) was carried out. Fifteen sources were included.
Indications and use of dexamethasone and prednisolone varied across the cited literature. An evidence
based practice viewpoint and appraisal of the literature was undertaken and the results collated.
Results: Analysis of the literature shows a clinical benefit of Dexamethasone in comparison to
Prednisolone when it comes to re-presentation, with a reduction in patient readmission and
re-presentation when using Dexamethasone compared to Prednisolone. Clinical benefit outside of this
parameter has not been proven. There was also a demonstrable effect on caregiver stress levels when
Dexamethasone was given compared to Prednisolone given ease of use. Some benefit with improved
tolerance with Dexamethasone compared to Prednisolone. There is also a potential cost benefit
involved in treating Croup with single dose Dexamethasone but this would need further exploration in
the New Zealand context.