Glucocorticoids effective for croup in children

Glucocorticoids effective for croup in children

Brian McAvoy
Clinical question

How effective are glucocorticoids for the treatment of croup in children aged up to 18 years?

Bottom line

Glucocorticoids improved croup symptoms at 2 hours (moderate‐certainty evidence), and the effect lasted at least 24 hours (low‐certainty evidence). Glucocorticoids reduced rates of return visits, hospital admissions and readmissions (moderate‐certainty evidence). Glucocorticoids reduced length of hospital stay by 15 hours (range 6 to 24 hours), but made no difference in need for additional treatments. There appeared to be no additional benefit from combined dexamethasone and budesonide in comparison with using either treatment alone. Few serious adverse events were reported related to short‐term treatment with glucocorticoids for croup.


It was not certain which type, amount and administration mode (oral, inhaled, injected) of glucocorticoids was best for reducing symptoms of croup in children.


Croup causes oedema of the throat and trachea, resulting in hoarseness, a barking cough and noisy breathing. Glucocorticoids can reduce swelling, making it easier to breathe.

Cochrane Systematic Review

Gates A et al. Glucocorticoids for croup in children. Cochrane Reviews, 2018, Issue 8. Art. No.: CD001955.DOI: 10.1002/14651858. CD001955.pub4. This review contains 43 studies involving 4565 participants.