• Jasmina Jocić
  • Zorica Živković Bolnica za dečje plućne bolesti i TB, KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija
  • Sanja Stanković Pedijatrijska ordinacija „Dečji svet“, Beograd, Srbija
  • Vesna Veković Bolnica za dečje plućne bolesti i TB, KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija


croup, corticosteroids, prevention, children


Croup is one of the most common causes of upper airway obstruction in young children. It is caused by viral infections, most often by Parainfluenza . Croup symptoms have a rapid onset, usually by night and include barky cough, inspiratory stridor, hoarseness and respiratory distress.  There is no causal therapy. Primarily is to calm down child and parents. Glucocorticoids are drugs of choice for treatment  of children with croup of all levels of severity. They may be administered orally, inhalatory, parenterally or rectally . Timely treatment with corticosteroids all of children with croup and those with severe respiratory distress with nebulized epinephrine can significantly decrease intubations, hospital admissions and recurrent visits to the doctor.


Harding T, Harding A. Multiple short courses of corticosteroids in children. Aust J Gen Pract. 2021;50(3):151-156.

Thabet A, Greenfield T, Cantor RM. Corticosteroid use in management of pediatric emergency conditions. Pediatr Emerg Med Pract. 2018;15(3)1-16.

Deshmukh CT. Minimizing side effects of systemic corticosteroids in children. Indian J Dermatol Venereol Leprol.2007;73(4):218-221.

Ferrara G, Petrillo MG, Giani T, et al. Clinical Use and Molecular Action of Corticosteroids in the Pediatric Age. Int J Mol Sci. 2019;20(2):444.

Rieder MJ. The child with multiple short courses of steroid therapy. Paediatr Child Health. 2003;8(4):226.

Phelan PD Landay LIOlinsky. Respiratory illness in children.2nd ed. CV Mosby, St. Louis.1982; 59-66.

The Royal Children’s Hospital Melbourne. Clinical practice guideline: Croup (laryngotracheobronchitis). Parkville, Vic: The Royal Children’s Hospital Melbourne, 2019.

Beubler E, Dittrich P. About the Therapy of Laryngotracheitis(Croup) : Significance of Rectal Dosage Forms. Pharmacology 2015;95:300–302.

Ortiz-Alvarez O. Acute management of croup in the emergency department. Paediatr Child Health. 2017;22(3):166-173.

Perretti M, Ahluwalia A. The microcirculation and inflammation: site of action for glucocorticoids. Microcirculation. 2000;7(3):147-61.

Russell KF, Liang Y, O'Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011;19;(1):CD001955.Update in: Cochrane Database Syst Rev. 2018;22;8:CD001955. PMID: 21249651.

Newman S. Improving inhaler technique, adherence to therapy and the precision of dosing: major challenges for pulmonary drug delivery. Expert Opin Drug Deliv. 2014;11(3):365-378.

Leiva-Fernández J, Leiva-Fernández F, Vázquez-Alarcón RL, García-Ruiz A, Prados-Torres D, Barnestein-Fonseca P. Study protocol for a randomized, controlled trial comparing the efficacy of two educational interventions to improve inhalation techniques in patients with chronic obstructive pulmonary disease (COPD): TIEPOC Study. Drugs Context. 2014;3:212261.

Hua S. Physiological and Pharmaceutical Considerations for Rectal Drug Formulations. Front Pharmacol. 2019;10:1196.

Turner C., Mya Thein N., Turner P., Nosten F., White N. J.Rectal pH in well and unwell infants. J. Trop. Pediatr.2012; 58 (4), 311–313.

Jannin V, Lemagnen G, Gueroult P, Larrouture D, Tuleu C. Rectal route in the 21st Century to treat children. Adv. Drug Deliv. Rev.2014;73:34–49.

Abolhassani M, Lagranderie M, Chavarot P, Balazuc AM, Marchal G. Mycobacterium bovis BCG induces similar immune responses and protection by rectal and parenteral immunization routes. Infect Immun. 2000;68(10):5657-5662.

Voskresensky Baričić T. Akutni subglotični laringitis – nova i učinkovita rektalna glukokortikoidna terapija. MEDIX. 2009;15(80/81):21.

Gates A, Gates M, Vandermeer B, et al. Glucocorticoids for croup in children. Cochrane Database Syst Rev. 2018;8(8):CD001955.

Bjornson CL, Johnson DW. Croup in children. CMAJ. 2013 Oct 15;185(15):1317-1323.






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