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Area of Science:

  • Pediatric Pulmonology
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Croup is a common childhood respiratory illness.
  • Glucocorticoids are frequently prescribed for croup management.
  • This review is an update of previous Cochrane reviews from 1999, 2004, and 2011.

Purpose of the Study:

  • To evaluate the efficacy and safety of glucocorticoids in treating croup in children aged 0 to 18 years.
  • To synthesize evidence from randomized controlled trials (RCTs) on the effects of glucocorticoids.

Main Methods:

  • Systematic search of multiple databases including CENTRAL, MEDLINE, and Embase.
  • Inclusion of 43 RCTs involving 4565 children with croup.
  • Data extraction, risk of bias assessment (Cochrane 'Risk of bias' tool), and GRADE certainty assessment.

Main Results:

  • Glucocorticoids significantly improved croup symptoms at two hours (moderate-certainty evidence).
  • Treatment reduced hospital length of stay by approximately 15 hours.
  • A reduced rate of return visits or re-admissions was observed (moderate-certainty evidence).

Conclusions:

  • Glucocorticoids are effective in reducing croup symptoms, hospital stays, and return visits.
  • The optimal glucocorticoid regimen (type, dose, administration) requires further investigation.
  • Evidence supports the use of glucocorticoids for pediatric croup management.