Dexamethasone Case Study Essay

Introduction and Clinical Question: Viral croup remains a common cause of upper respiratory obstruction in the pediatric population and its barking cough can often be heard in the pediatric clinic and local emergency departments. Multiple studies have shown the use of glucocorticoids results in a faster recovery with fewer return visits and hospital admissions, as well as a decrease in the use of epinephrine (2). However, in cases were the patient or caregiver refuses an injection or where injections are not available, would a one-time oral dose of dexamethasone treat as effectively as an IM dose?
Patient Case: A 36 month old female presented to the emergency department with inspiratory stridor and a seal-like cough. The patient’s mother states that she has been “a little fussy” and relays that the illness began a day prior with rhinorrhea. The patient and her mother deny any abdominal pain, nausea, vomiting, or diarrhea. The patient was mildly tachypneic, but was not in any significant respiratory distress. …show more content…
Although the above trial was published in 2002 it demonstrates the effectiveness of treatment and is corroborated by the literature review. Dexamethasone is effective and relatively inexpensive, making it a great choice. It is available as a tablet, oral liquid, or injectable. The oral liquid is said to taste rather unpleasant, but the injectable preparation can be mixed with syrup and given orally (2). The standard dose of 0.6mg/kg is used for IM administration. For oral administration a smaller dose of 0.15mg/kg can be administered for mild croup and a dose of 0.6mg/kg for moderate-severe croup (1,2). If parents know that they can seek treatment for their children that does not involve injections, they may be more likely to bring the child in for treatment early in the illness, further reducing the chance of negative