Corticosteroid Treatment of Laryngotracheitis v Spasmodic Croup in Children

We compared the efficacy of high-dose dexamethasone sodium phosphate (0.6 mg/kg) in laryngotracheitis (LT) v spasmodic croup (SC) in 72 children (age range, 8 months to 8 years) using a double-blind randomized protocol that measured the individual change in respirations as an objective variable to evaluate the outcome. Administration of dexamethasone did not change the respirations in the patients with LT and significantly decreased the respirations in the patients with SC, compared with the placebo group. Since, in most cases, the pediatrician will be able to differentiate between LT and SC at admission by history and clinical signs, it seems that steroid treatment should be avoided in cases of LT and may be of benefit in some cases of SC.