Presented by Casey Ward, MD
- In doses of 1-4 mg, budesonide does not affect markers of systemic corticosteroid activity
- Budesonide is better than placebo at preventing admission for croup in mild to moderate cases
- Patients treated with epinephrine have significantly less stridor than those treated with budesonide
- Children treated with dexamethasone and nebulized budesonide have better clinical response than those treated with dexamethasone and nebulized saline
Epinephrine and dexamethasone are still the gold standards for treatment of stridor at rest in children with croup. Budesonide is a safe drug. In doses 4 mg or below, there does not appear to be any systemic steroid effect. The evidence is not conclusive whether budesonide helps in an additive fashion when used with dexamethasone or epinephrine.
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Klassen TP, Watters LK, Feldman ME et al. “The efficacy of nebulized budesonide in dexamethasone-treated outpatients with croup”. Pediatrics 1996. 97(4): 463-466.