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Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!
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March 23, 2022 at 3:39 pm
Many experts and reviews have advocated for a lower 0.15 mg/kg dose of dexamethasone in croup, including this retrospective study describing 11 years of data at a single hospital showing no change in outcomes with the lower dosing https://pubmed.ncbi.nlm.nih.gov/19682017/ . However, a 2018 Cochrane Systematic Review https://pubmed.ncbi.nlm.nih.gov/30133690/ identified only 6 studies, and characterized the quality of evidence available as low. Higher doses at 0.6 mg/kg appeared to lead to greater reduction in croup scores early on, but the difference was not maintained at 12 hours. Studies did not report differences in return visits or readmission rates.