Single dose of oral dexamethasone for outpatient croup

BMJ 1996;313:1081 (26 October)

Letters

Single dose of oral dexamethasone for outpatient croup

Failure to follow up all patients is a concern

EDITOR,--G C Geelhoed and colleagues conclude from their studythat oral dexamethasone at a dose of 0.15 mg/kg is effectivein reducing return to medical care in children with mild croup.¹The sample size seems adequate, though on the borderline fordetecting a 90% reduction, but the fact that four children werenot followed up is of concern. If the two children lost to followup in the treatment group had in fact sought some medical care(or even died) this would have meant that the difference inoutcome between the two groups was not significant by Fisher'sexact test. We wonder why the calculation of sample size assumedsuch a large reduction as 90%. Was this a retrospective calculation?

The final key message states that all children presenting withcroup should be considered for steroids. Before the authors'findings can . . . [Full text of this article]

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Relevant Article

Efficacy of a small single dose of oral dexamethasone for outpatient croup: a double blind placebo controlled clinical trial: G C Geelhoed, J Turner, and W B G Macdonald
BMJ 1996 313: 140-142. [Abstract] [Full Text]