3.4 Croup

Management in primary care

For mild croup (seal-like barking cough but no stridor or sternal/intercostal recession at rest, and no other factors warranting a lower threshold for admission, such as chronic lung disease, age under 3 months, or immunodeficiency):

  • Dexamethasone 150micrograms/kg for one dose OR
  • Prednisolone 1-2mg/kg for one dose
  • Advise either paracetamol or ibuprofen for distress caused by fever (not solely to reduce body temperature)

Prior to hospital admission:

If available promptly:

  • Dexamethasone 150micrograms/kg for one dose OR
  • Prednisolone 1-2 mg/kg for one dose

Secondary care

Secondary care clinicians seeing patients with suspected croup should follow the ESHT guidelines ‘Clinical Guideline for the Management of Croup

Neither product may be readily available in primary care – it is advised to check with the patient’s local community pharmacy before prescribing

50 tablet
1 ml

Can be crushed and mixed with food – off-license use

30 tablet
30 tablet

In primary care can only be supplied in multiples of 5

10 unit dose
  • First Line Drugs
  • Second Line Drugs
  • Specialist Initiated Drugs with Shared Care Guidelines
  • Specialist Only Drugs
  • Mixed Status