Do Glucocorticoids Improve Symptoms and Reduce Return Visits or Admission Rates Among Children With Croup?

Authors included 43 randomized controlled trials comprising 4,565 patients from an initial 79 studies discovered during the literature search. Of these, 21 (48.8%) evaluated ED patients, 21 (48.8%) evaluated hospitalized patients, and 1 (2.3%) evaluated patients presenting to a physician outpatient office. Twenty-nine studies (67.4%) measured croup scores; of these, 17 (58.6%) used the Westley score, 11 (37.9%) used author-created scales, and 1 (3.4%) used the Downes score. Compared with placebo, glucocorticoids improved symptoms of croup as measured by standardized mean difference at intervals from medication administration at 2 hours (standardized mean difference –0.65; 95% CI –1.13 to –0.18) to 24 hours (standardized mean difference –0.86; 95% CI –1.40 to –0.31).

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