Croup

- Illness of children younger than 6 years of age with peak incidence at 7-36 months.

- Systemic/nebulized corticosteroids have been proven to lessen severity and duration of symptoms, and hospitalization.

- Nebulized epinephrine is indicated in severe respiratory distress.

- Give blow-by oxygen if hypoxia (O2 sat < 92% on room air).

- Antitussives and decongestants not indicated. Sedation contraindicated.

 
Usual Pathogens

Viruses

No antibiotic therapy recommended

Empiric Therapy

Dose

Duration
Dexamethasone 0.6mg/kg PO/IM/IV Once. May repeat dose in 24h if symptoms recur
or    
Budesonide 2mg in 4mL sterile water via nebulizer Once. May repeat dose in 24h if symptoms recur

Severe

Empiric Therapy Dose Duration
Racemic epinephrine 2.25% 0.5mL in 3mL NS or sterile water via nebulizer Repeat as necessary
or    
L-epinephrine 1:1,000 solution - 5mL via nebulizer Repeat as necessary