From the Research
For an 18-month-old child weighing 12 kg with acute croup, the recommended dose of oral prednisone is 1-2 mg/kg as a single dose, which would be 12-24 mg, with a typical dose being 20 mg (approximately 1.7 mg/kg) given once. This dose is based on the most recent and highest quality evidence available, which prioritizes the reduction of morbidity, mortality, and improvement of quality of life for the patient 1.
The medication should be administered as soon as possible after diagnosis to reduce airway inflammation and improve symptoms. Prednisone works by reducing inflammation in the larynx and trachea, which helps decrease the stridor, barking cough, and respiratory distress associated with croup. The onset of action is typically within 4-6 hours, and the effects last for about 24 hours. A single dose is usually sufficient for most cases of croup, but if symptoms persist or worsen, medical reassessment is necessary.
Some key points to consider when treating croup with oral prednisone include:
- Ensuring the child stays well-hydrated and maintains adequate oral intake while recovering from croup
- Monitoring for potential side effects, although they are rare with a single dose of prednisone
- Considering the use of a liquid formulation of prednisone, which may be easier for a young child to take
- Being aware of the potential need for additional treatment or hospitalization if symptoms do not improve or worsen, as discussed in studies on croup management 2, 3, 4, 5.
However, the most critical factor in determining the dose of oral prednisone for acute croup termination is the weight of the child and the severity of the symptoms, as outlined in the initial study 1.