This post is in response to a very specific question from a local GP. The question wasn’t about recognising croup or even about the best evidence-based treatment. Recognising croup is fairly straightforward. There is pretty much consensus on the best management of croup.
The question was about the practicalities.
The evidence for the ideal management of croup has given us a fairly straightforward and reasonably robust answer: a single 0.15mg/kg dose of oral dexamethasone.
Sounds simple, doesn’t it?
The difficulty is that a single dose is actually quite problematic from a pharmacy point of view. As a result, the decision isn’t always about the best available evidence. It might also be about the best available medication and formulation. To determine the answer to this question, we need to go back a couple of steps.