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Role of steroids in croup and beta agonists in bronchiolitis

  • Symposium : Controversies in Pediatrics-Part II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

The administration of corticosteroids by various routes in the treatment of croup remains controversial as studies with varying designs and outcome measures have reported conflicting results. However, meta-analysis supports the use of steroids in croup. A dose equivalent to or greater than 100 mg/kg body weight of hydrocortisone, administered orally or parenterally appears to be effective. Nebulized budesonide in a dose of 1,000 micrograms, when dosages are given 30 minutes apart is also effective. The L-epinephrine is as effective as racemic epinephrine and should be used to relieve symptoms with or without steroids. Summarizing the value of beta agonists, for treatment of bronchiolitis is rather challenging. Beta agonists offer significant relief to only a subgroup of infants, with bronchiolitis, albeit, it remains a challenge to identify these infants prospectively. Availability of RSV immune globulin for prevention of RSV disease in highrisk infants and better defining the role of ribavirin for selected patients may offer additional avenues to the treating physician.

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Authors and Affiliations

  1. Department of Pediatrics and Human Development, Michigan State University, East Lansing, 48824-1316, Michigan, MI, USA

    Arivoli Veerappan M.D. (Professor) & Ashir Kumar

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  1. Arivoli Veerappan M.D.
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  2. Ashir Kumar
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Veerappan, A., Kumar, A. Role of steroids in croup and beta agonists in bronchiolitis. Indian J Pediatr 63, 577–581 (1996). https://doi.org/10.1007/BF02730799

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