Nebulised corticosteroids are the treatment of choice

Although croup is one of the commonest childhood complaints, its treatment has been empirical at best. Traditional management at home consists of creating a warm moist atmosphere by placing the child in a steam filled bathroom with the hot water taps running, but there is no objective evidence that this treatment is effective. Nebulised adrenaline is commonly prescribed in North America, and although it is of proved benefit, its effect is short lived.1 Corticosteroids have been advocated, but until recently their use was contentious because of conflicting reports.2 3 4

Croup, or laryngotracheobronchitis, is most commonly seen in children aged 6 months to 4 years. It is caused by viral infection, usually with parainfluenza virus, although infection with influenza, respiratory syncitial virus, or rhinovirus may cause a similar clinical picture. Croup is characterised by a harsh, barking, seal-like cough, stridor, and hoarse voice, with …