The effectiveness of glucocorticoids in treating croup: meta-analysis.
نویسندگان
چکیده
OBJECTIVE To determine the effectiveness of glucocorticoid treatment in children with croup. DESIGN Meta-analysis of randomized controlled trials that examine the effectiveness of glucocorticoid treatment in children with croup. MAIN OUTCOME MEASURES Score on scale measuring severity of croup,use of co-interventions (epinephrine, antibiotics, or supplemental glucocorticoids), length of stay in the emergency department or the hospital, and rate of hospitalization. RESULTS Twenty-four studies met the inclusion criteria. Glucocorticoid treatment was associated with an improvement in the croup severity score at 6 hours with an effect size of -1.0 (95% confidence interval [CI] -1.5 to -0.6) and at 12 hours -1.0 (-1.6 to -0.4); at 24 hours, this improvement was no longer significant (-1.0, -2.0 to -0.1). There was a decrease in the number of epinephrine treatments needed in children treated with glucocorticoids: a decrease of 9% (95% CI 2% to 16%) among those treated with budesonide and of 12% (4% to 20%) among those treated with dexamethasone. There was also a decrease in the length of time spent in the emergency department (-11 hours, 95% CI -18 to 4 hours) and, for inpatients, hospital stay was reduced by 16 hours (-31 to 1 hour). Publication bias seems to play a part in these results. CONCLUSIONS Dexamethasone and budesonide are effective in relieving the symptoms of croup as early as 6 hours after treatment. Fewer co-interventions are used, and the length of time spent in the hospital is decreased in patients treated withglucocorticoids.
منابع مشابه
Glucocorticoids in the treatment of croup: barking up the right tree.
Croup, a syndrome characterized by a barking cough, inspiratory stridor and respiratory distress, afflicts up to 3% of children less than 6 years of age each year. The syndrome is usually caused by infection with a virus, most often parainfluenza 1 virus, and this infection is believed to cause inflammation of the larynx and trachea, which results in the characteristic symptoms. Admission rates...
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عنوان ژورنال:
- The Western journal of medicine
دوره 171 4 شماره
صفحات -
تاریخ انتشار 1999