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Croup — MRCGP AKT MCQ

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EasyPaediatricsCroupMRCGP AKTMRCEM SBAUKMLAPARA

A 2-year-old boy has a barking cough and stridor at rest, consistent with moderate croup. He is alert and able to take oral medication. Which corticosteroid regimen is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Dexamethasone 0.15 mg/kg PO as a single dose

The recommended treatment is a single oral dose of dexamethasone 0.15 mg/kg. Stridor at rest indicates at least moderate croup, for which corticosteroid treatment is indicated. Dexamethasone 0.05 mg/kg is below the recommended dose. Although doses up to 0.6 mg/kg have been used, repeated 8-hourly dosing is unnecessary and increases corticosteroid exposure. Prednisolone can be used when dexamethasone is unavailable, but a single 1 mg/kg dose is less suitable than the recommended dexamethasone regimen and may require a second dose. The child also requires appropriate clinical observation and escalation according to respiratory severity.

Reference: Rosemont Pharmaceuticals Limited. Dexsol 2 mg/5 mL Oral Solution, Summary of Product Characteristics, section 4.2: Childhood Croup. Revised 2025. https://www.medicines.org.uk/emc/product/1344/smpc