The use of corticosteroids in croup: a survey

The use of corticosteroids to treat laryngotracheobronchitis (croup) is controversial. Although some evidence supports the efficacy of treating hospitalized patients with croup, there is no published information on the use of corticosteroids in the outpatient population. We sought to determine what the current practice in the use of corticosteroids to treat croup was in our community. One hundred thirty-eight questionnaires were mailed to pediatricians and family practitioners in our geographic region. One hundred twelve surveys were completed and returned. The majority of responding physicians used corticosteroids to treat both inpatients and outpatients with croup at least some of the time. A significantly greater percentage used them to treat hospitalized patients (93%) compared with nonhospitalized patients (68%). The drug used by the majority of respondents was dexamethasone (87% in treating inpatients, 56% in treating outpatients). The initial dosage, cumulative dosage, number of doses, and route of administration varied greatly among the respondents. This survey demonstrates that most physicians in our area are using corticosteroids to treat both hospitalized and non-hospitalized patients with croup. However, the form of drug used, dosing regimen, and route of administration are highly variable. This survey highlights the need for clinical studies to assess the efficacy of using corticosteroids to treat outpatients with croup and to determine how best to use them.