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The Treatment of Croup with Nebulized Budesonide and Intramuscular Dexamethasone

Journal of the Korean Pediatric Society 1998;41(3):331-337.
Published online March 15, 1998.
The Treatment of Croup with Nebulized Budesonide and Intramuscular Dexamethasone
Jung Woo Lee, Young Ho Rah, Chong-Woo Bae, Sa Jun Chung, Yong Mook Choi
Department of Pediatrics, College of M edicine, Kyung H ee University, Seoul, Korea
크룹(Croup)에서 Nebulized Budesonide와 Dexamethasone 주사의 치료효과 비교
이정우, 나영호, 배종우, 정사준, 최용묵
경희대학교 의과대학 소아과학교실
Correspondence: 
Jung Woo Lee, Email: 1
Abstract
Purpose
: Steroids have anti-inflammatory effects which reduces inflammation and edema of the tissue. Thus, corticosteroids have been used for treatment of croup. The aim this study is to compare and assess the effects of intramuscularly injected dexamethasone and nebulized budesonide in treatment of moderate or severe croup.
Methods
: Between July 1995 to June 1996, we have assessed 44 inpatients with croup syndrome, of which 20 patients have been treated by intramuscularly injected dexamethasone and 24 patients by nebulized budesonide. We measured the croup symptom scores and arterial oxygen saturation at initial, at 4 hours, 12 hours and 24 hours after treatment.
Results
: The sex ratio and mean age of patients were 2.3:1 and 18.7¡¾9.1 months in budesonide treatment group and 3:1 and 22.3¡¾13.1 months in dexamethasone treatment group, respectively. There was no significant difference(P > 0.05) among the two groups. In budesonide treatment group, the symptom scores were 7.5¡¾4.5 at initial and 4.5¡¾1.3 at 4 hours after treatment. These were statistically significant(P < 0.005). In the dexamethansone treatment group, the symptom scores were 7.6¡¾1.2 at initial and 5.1¡¾1.2 at 4 hours after treatment. They were statistically significant(P < 0.005). Arterial oxygen saturations were significantly different(P < 0.005) between initial and 4 hours after treatment in both groups. There were no side effects in the budesonide treatment group.
Conclusion
: Nebulized budesonide has the same effects with intramuscularly injected dexamethasone in treatment of croup whether the severity is moderate or extreme. Therefore it should provide an effective means of treatment for moderate or severe croup patients without systemic side effects.
Key Words: Croup, Treatment modality, Budesonide, Dexamethasone


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