Corticosteroid Treatment for Severe Croup

Dosing Recommendations

• The maximum dose of prednisolone should not exceed 60 mg 1, 2
• Prednisolone should be given as a single morning dose to minimize adrenocortical suppression 3

Administration Considerations

• Oral administration is preferred unless the child is vomiting or in severe respiratory distress, and for children unable to take oral medication, intramuscular dexamethasone should be considered as an alternative 3

Distinguishing Croup Steroid Dosing from Asthma Steroid Dosing

Dosing Guidance

• Do not apply asthma steroid regimens (1–2 mg/kg per day for multiple days) to croup; the recommended regimen for croup is a single oral dose of prednisolone 1 mg/kg. This clarification helps avoid dosing errors between two distinct respiratory conditions. 4