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Croup.

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Updated: Apr 23, 2026

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Croup.

David Wyatt Johnson1

  • 1Department of Pediatrics, University of Calgary, Calgary, Canada.

BMJ Clinical Evidence
|September 30, 2014
PubMed
Summary

Corticosteroids and nebulised adrenaline are effective treatments for moderate to severe croup in children. This systematic review evaluates various interventions for croup, a common childhood respiratory obstruction.

Area of Science:

  • Pediatric respiratory medicine
  • Evidence-based medicine
  • Systematic reviews

Background:

  • Croup, a common childhood illness, causes upper airway obstruction with symptoms like barking cough and stridor.
  • It affects approximately 3% of children annually, primarily between 6 months and 3 years.
  • Croup must be distinguished from other serious conditions like epiglottitis and foreign body aspiration.

Purpose of the Study:

  • To systematically review the effectiveness and safety of various treatments for mild and moderate to severe croup in children.
  • To answer key clinical questions regarding therapeutic interventions for pediatric croup.

Main Methods:

  • Conducted a systematic review of medical literature up to November 2013.
  • Searched major databases including Medline, Embase, and The Cochrane Library.

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  • Included harms alerts from regulatory agencies like the FDA and MHRA.

    • Main Results:

    • Included 19 studies in the systematic review.
    • Performed a GRADE evaluation to assess the quality of evidence for different interventions.
    • Identified several interventions for review.

    Conclusions:

    • Corticosteroids, including dexamethasone and oral prednisolone, are effective for treating croup.
    • Nebulised adrenaline (racemate and L-adrenaline) is also effective for moderate to severe croup.
    • The review presents data on the effectiveness and safety of corticosteroids, nebulised budesonide, heliox, humidification, and nebulised adrenaline.