Croup
Management of croup
Corticosteroid choices.
Prednisolone
Prednisolone 5mg tablets
Severe croup (before transfer to hospital) or mild croup that might cause complications (before transfer to hospital):
1-2 mg/kg.
Prednisolone 5mg/5ml oral solution unit dose
Severe croup (before transfer to hospital) or mild croup that might cause complications (before transfer to hospital):
1-2 mg/kg.
Dexamethasone
Dexamethasone 2mg/5ml oral solution
For dose, refer to BNF for Children.
Prescribing Notes:
- For acute croup, oral prednisolone acts as quickly and is less expensive than nebulised budesonide.
- Prednisolone oral solution and soluble tablets are restricted to use in patients who are unable to swallow tablets. These preparations are considerably more expensive than the standard tablets.
- Prednisolone tablets may be dispersed in water as an alternative to soluble or liquid preparations. This is a more cost-effective option.
- Prednisolone oral solution 5mg/5ml, single-dose unit presentation should not be prescribed for doses exceeding 30mg daily.
- While awaiting transport to hospital, children suffering acute croup with severe respiratory difficulty may be treated with nebulised adrenaline. Children under 5 years may receive nebulised adrenaline at an initial dose of 2mg (2ml of adrenaline 1mg/ml) with 2ml normal saline; children above 5 years may receive nebulised adrenaline at an initial dose of 4mg (4ml of adrenaline 1mg/ml).
History Notes
30/08/2023
East Region Formulary content agreed - ERFC 09/08/2023.