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Case Reports
. 2017 Nov 30:11:241-261.
doi: 10.2174/1874434601711010241. eCollection 2017.

A Systematic Review and Comprehensive Critical Analysis Examining the Use of Prednisolone for the Treatment of Mild to Moderate Croup

Anna Catherine Elliott  1 , Graham R Williamson  2
Affiliations
Case Reports

A Systematic Review and Comprehensive Critical Analysis Examining the Use of Prednisolone for the Treatment of Mild to Moderate Croup

Anna Catherine Elliott et al. Open Nurs J. .

Abstract

Background: Many randomised control trials and systematic reviews have examined the benefits of glucocorticoids for the treatment of croup in children, but they have reported mainly on dexamethasone as an oral treatment for croup. No systematic reviews have examined prednisolone alone.

Aim: To determine in a systematic review of the literature whether a single dose of oral prednisolone is as effective as a single dose of dexamethasone for reducing croup symptoms in children.

Search strategy: A detailed search was conducted on the following databases: CINAHL, MEDLINE EBSCO, MEDLINE, OVID, PubMed, The Cochrane Library, ProQuest, EMBASE, JBI, Sum search, and OpenGrey. Study authors were contacted.

Selection criteria: Randomised Controlled Trials, clinical trials or chart reviews which examined children with croup who were treated with prednisolone alone, or when prednisolone was compared to a dexamethasone treatment and the effectiveness of the intervention was objectively measured using croup scores and re-attendance as primary outcomes.

Data collection and analysis: Following PRISMA guidelines for systematic reviews, relevant studies were identified. Scores were graded agreed by two independent reviewers using QualSyst.

Main results: Four studies met the inclusion criteria, but were too heterogeneous to combine in statistical meta-analysis. The result suggests that although prednisolone appears as effective as dexamethasone when first given, it is less so for preventing re-presentation. Trial sample sizes were small, making firm conclusions difficult, however, a second dose of prednisolone the following day may be useful. More research including cost-benefit analysis is needed to examine the efficacy of prednisolone compared to dexamethasone.

Keywords: Corticosteroids; Croup; Dexamethasone; Prednisolone; QualSyst; Systematic review.

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Figures

Fig. (1)
Fig. (1)
Combined results of the searches in a PRISMA flow diagram.
See this image and copyright information in PMC

References

    1. National Institute for Health and Care Excellence (NICE) Croup. 2012. Available from: http://cks.nice.org.uk/croup . Cited: 11 July 2016.
    1. Atkinson P.R., Boyle A.A., Lennon R.S. Weather factors associated with paediatric croup presentations to an Australian emergency department. Emerg. Med. J. 2014;31(2):160–162. doi: 10.1136/emermed-2012-201876. - DOI - PubMed
    1. Beattie J., Patton J. Shared care guideline reduces referrals for children with croup. 2001. Available at: https://www.guidelinesinpractice.co.uk/ mar_01_beattie_croup_march01 .
    1. Johnson D. Available at: http://clincialevidence.bmj.com/x/ systematic-review/0321/overview.html. 2014. (Accessed: 30 June 2016)
    1. Brown S. GP guide to the assessment and management of croup. Prescriber. 2006;17(16):25–4. doi: 10.1002/psb.411. - DOI

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