Dexamethasone Treatment for Croup in Children

Clinical Considerations

• For laryngotracheobronchitis (croup), nebulized epinephrine may be used in conjunction with dexamethasone for more severe cases: 0.5 mL/kg of 1:1000 solution (maximum: 5 mL) administered by nebulizer, as recommended by the American Academy of Pediatrics 1, 2
• If racemic epinephrine is not available, L-epinephrine (1:1000) can be substituted at a dosage of 0.5 mL/kg up to 5 mL, according to the American Academy of Pediatrics 1, 2

Treatment Algorithm

• For moderate to severe croup, consider nebulized epinephrine for significant respiratory distress, as suggested by the American Academy of Pediatrics 1, 2