Pediatric emergency care
October 16, 2026 · via Europe PMC
Using a Single Dose of Dexamethasone at 0.6 Versus 0.15 mg/kg of Body Weight for the Treatment of Croup: A Multicenter Retrospective Chart Review.
Aregbesola A, Turnbull J, Oketola B, +5 more, Johnson D.
AI summary — for doctors, generated from the abstract only
A ten-fold lower dexamethasone dose for croup appeared to give similar return-visit rates, but the comparison is very imbalanced.
What was studied
Multicenter retrospective chart review of 14,205 children across 4 pediatric EDs (2017-2019), comparing 0.15 mg/kg (n=172) with 0.6 mg/kg (n=13,265) dexamethasone.
Key findings
- Return ED visits within 7 days were 2.9% and 4.1%, respectively.
- The difference was not statistically significant.
- Hospitalizations and adverse events were secondary outcomes.
Clinical relevance
Croup is common, and dose optimization affects practice and steroid exposure.
Who should care
Limitations
The low-dose group was tiny, retrospective and non-randomized, so equivalence cannot be concluded.
Do not change from standard dosing based on this study; a randomized trial is needed.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To compare the effectiveness and adverse events associated with treating children with croup with dexamethasone at 0.15 versus 0.6 mg/kg body weight.
Methods
This retrospective cohort study included children (younger than 18 y) with a clinical diagnosis of croup in 4 pediatric emergency departments (EDs) between January 2017 and December 2019. The primary outcome was return visit to the ED for croup within 7 days, and the secondary outcomes were hospitalization within 7 days and occurrence of adverse events within 30 days. Both χ2 tests and logistic regression models were used to compare differences in the proportions of children with ED return visits, hospitalizations, and adverse events associated with dose.
Results
We included 14,205 children in the final analysis. Of the 13,437 croup episodes from children treated with dexamethasone at 0.15 mg/kg (n=172) or 0.6 mg/kg (n=13,265), 2.9% and 4.1%, respectively, were ED return visits within 7 days following treatment. The difference in the proportion of ED return visits following treatment with the 2 doses was not statistically significant (1.2%; 95% CI: -1.31 to 3.76). In a multivariable-adjusted model, 0.15 mg/kg was not associated with ED return visits within 7 days [adjusted odds ratio (aOR)=0.88; 95% CI: 0.31-1.97], but was associated with hospitalization (aOR=3.18; 95% CI: 1.52-6.00). A total of 135 (1%) of all croup episodes had at least 1 adverse event within 30 days. Of those treated with 0.15 or 0.6 mg/kg, 1.2% and 1%, respectively, had at least 1 adverse event within 30 days. The most common adverse event was pneumonia (0.8%).
Conclusions
Our findings suggest that low-dose dexamethasone, 0.15 mg/kg, may be as effective as 0.6 mg/kg with comparable proportions of ED return visits and adverse events within 7 days. However, low-dose dexamethasone was associated with increased hospitalization. Clinicians should weigh the potential risk of hospitalization when choosing 0.15 mg/kg of dexamethasone.
DOI
10.1097/pec.0000000000003738
PMID
42899825
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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