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Croup — RACP Paediatrics MCQ

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EasyRespiratoryCroupRACP Paediatrics

A 2-year-old girl presents with a barking cough, inspiratory stridor at rest, and mild subcostal recession. She is alert and drinking well. According to the RCH Melbourne Clinical Practice Guidelines, what is the most appropriate corticosteroid treatment?

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Correct answer: E — Dexamethasone 0.15 mg/kg orally

The RCH Melbourne CPG for croup recommends oral dexamethasone 0.15 mg/kg as the first-line corticosteroid, or prednisolone 1 mg/kg. Nebulised budesonide 2 mg is reserved for children unable to tolerate oral steroids. A single dose is recommended. The 0.6 mg/kg dose is used in some international guidelines but the RCH CPG now uses 0.15 mg/kg.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Croup (Laryngotracheobronchitis)