Repeated dose inhaled budesonide versus placebo in the treatment of croup

Objective: To investigate the efficacy and tolerance of 12-hourly dosing with 2 mg 4 mL–1 of inhaled budesonide versus placebo in patients admitted to hospital with moderate/severe croup. Method: Eighty-two children hospitalised with croup received either 2 mg 4 mL–1 of budesonide or placebo 12 hourly (maximum four doses) via Ventstream® nebuliser in a randomised, double-blind manner. Croup scores were performed at 0, 2, 6, 12, 24, 36 and 48 h from initial nebulisation whilst the patient remained hospitalised. Follow-up assessments were made 1 and 3 days after discharge. Results: Improvement was observed in the budesonide group over the 12-h dosing interval when compared to placebo (P = 0.04). Time to attain a significant clinical improvement was superior in the budesonide group (P = 0.01). Three days after discharge seven of 32 placebo-treated patients and one of 34 budesonide-treated patients had sought further medical follow-up (P = 0.02). Conclusion: Twelve-hourly dosing with inhaled budesonide significantly improved symptoms of croup as well as decreased relapse rates when compared with placebo.GW Roberts, VV Master, RE Staugas, JV Raftos, DW Parsons, KP Coulthard and AJ Marti