A comparison of oral prednisolone and oral dexamethasone in children with croup: a prospective, randomised, double blinded multicentre trial

INTERVENTION: Group 1 ‐ oral prednisolone 1 mg/kg oral liquid, single dose; Group 2 ‐ oral dexamethasone 0.15 mg/kg oral liquid, single dose; CONDITION: Croup (laryngotracheitis, laryngotracheobronchitis) PRIMARY OUTCOME: Unscheduled medical re‐attendance rate, as assessed by follow‐up telephone call Westley Croup Score (a validated measure of croup severity, based on clinical observations of stridor, retractions, air entry, cyanosis, and level of consciousness) SECONDARY OUTCOME: Admission rate to Emergency Department Observation ward Admission rate to hospital ward Admission rate to Intensive Care Unit Adverse clinical events, other than vomiting (for example skin rash, changes in behaviour or appetite), as reported by treating staff and as reported by caregivers at follow‐up telephone call Duration of hospital admission or observation Duration of stay in the Emergency Department Hospital re‐admission rate for croup symptoms (stridor or breathing difficulty), as assessed by follow‐up telephone call Hospital re‐admission rate for non‐croup symptoms Incidence of Vomiting Need for definitive airway (tracheal intubation or surgical airway), as recorded by treating staff, ie whether or not a definitive airway was placed (decision at the discretion of treating doctor). Need for nebulised adrenaline (epinephrine), as recorded by treating staff, ie whether or not nebulised adrenaline was administered (decision at the discretion of treating doctor). Number of additional doses of steroid given after trial drug Unscheduled Hospital re‐attendance rate INCLUSION CRITERIA: Clinical diagnosis of croup Age 6 months to 10 years Weight no more than 20 kg Parents contactable by telephone Parents speak English