From the Research
The maximum dose of dexamethasone for croup is 12 mg, though typical dosing is 0.6 mg/kg (maximum 12 mg) given as a single dose, as supported by the study published in the International Journal of Pediatric Otorhinolaryngology 1.
Key Points
- Dexamethasone is the preferred corticosteroid for croup due to its long half-life (36-72 hours), which provides sustained anti-inflammatory effects from a single dose.
- The medication works by reducing airway inflammation and edema in the larynx and trachea, which helps relieve the characteristic barking cough and stridor associated with croup.
- Onset of action typically occurs within 2-3 hours, with maximum benefit seen around 6 hours after administration.
- While oral administration is preferred due to better compliance and less trauma, intramuscular injection can be used if oral administration isn't possible.
- For severe cases requiring hospitalization, additional doses may be considered, but this should be determined on a case-by-case basis by the treating physician.
Evidence Summary
- A study published in the International Journal of Pediatric Otorhinolaryngology found that dexamethasone 0.15 mg/kg and 0.6 mg/kg are equally effective in the treatment of moderate to severe croup, with a maximum dose of 12 mg 1.
- Another study published in Pediatric Pulmonology found that oral dexamethasone 0.15 mg/kg is as effective as 0.3 or 0.6 mg/kg in relieving symptoms and results in a similar duration of hospitalization in children with croup 2.
- However, the most recent and highest quality study should be prioritized, which in this case is the study published in the International Journal of Pediatric Otorhinolaryngology 1.