Dexamethasone in Croup

THE VALUE of corticosteroids in the treatment of croup has not been convincingly established. Some authors have claimed that corticosteroid therapy reduced or shortened the duration of airway obstruction so that fewer patients required tracheostomy.1,2Skowron and his associates3were able to demonstrate in a controlled study that the duration of fever, stridor, sternal retractions, and hospital stay were significantly reduced in corticosteroid treated patients, but concluded that the potential risk of serious side effects outweighed these advantages. Other workers have been unable to show measurable benefit from steroid therapy.4-6 Croup is a common disorder in young children, and therapy may occasionally include tracheostomy. It therefore seemed important to determine in a carefully controlled study whether the course of the disease could in fact be alleviated by the administration of corticosteroids. A preliminary pilot study carried out during 1964 and 1965 by D. Kaufman, MD, and J.