Effect of Nebulized Steroid (Budesonide) and Parenteral Steroid (Dexamethasone) on Children with Croup

Ahn, Seon Mee; Sohn, Jung Ae; Jung, Chul Zoo; Lee, Dong Jin; Lee, Young Hwan; Park, Yong Hoon

Abstract

PURPOSE: This prospective study was conducted to evaulate the effect of nebulized steroid (budesonide) and parenteral steroid (dexamethasone) on chidren with croup.
METHODS
Twenty nine infants and children (6months-5years of age) admitted to hospital with croup were randomly assigned to receive either 1mg (4ml) of nebulized budesonide (17 patients) or 0.6mg/kg intramuscular injection of dexamethasone sodium phosphate (12 patients). Total croup score, heart rate and respiratory rate of patients were assessed on admission, 30 minutes, 2 hours, 6 hours, 12 hours and 24 hours after treatment, respectively.
RESULTS
1) In total cases, total croup score were significantly decreased at 30 minutes after treatment in the group treated with nebulized budesonide (p<0.01) but at 2 hours after treatmetn in the group treated with dexamethasone (p<0.05). 2) In mild cases (total croup score<5), total croup score were significantly decreased at 2 hours after treatment in the both group (p<0.05). 3) In moderate to severe cases (total croup score> or =5), total croup score were significantly decreased at 30 minutes after treatment in the group treated with nebulized budesonide (p<0.05). But in group treated with dexamethasone, there were no statistical significance because of small cases. 4) Respiratory rate was decreased after treatment in the both group, but significantly decreased at 2 hours after treatment in the group treated with dexamethasone (p<0.05). 5) Heart rate was decreased after treatment in the both group, but significantly decreased at 30 minutes after treatment in the group treated with dexamethasone (p<0.05). 6) There were no significant side effects in the both group.
CONCLUSIONS
We conclude that both nebulized budesonide and parenteral dexamethasone were effective in treatment of croup, and that nebulized budesonide leads to more rapid clinical improvement in children with croup, especially moderate to severe one.