A randomized trial of a single dose of oral dexamethasone for mild croup
A randomized trial of a single dose of oral dexamethasone for mild croup
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DOI：
10.1056/nejmoa033534
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发表时间：
2004-09-23
影响因子：
158.5
通讯作者：
Johnson, DW
中科院分区：
文献类型：
--
作者：
Bjornson, CL;Klassen, TP;Johnson, DW
背景：地塞米松治疗中重度哮喘的益处是确凿的。然而，大多数患有哮喘的儿童都有轻微的症状，目前还不清楚他们是否会从地塞米松治疗中获得与更严重疾病的儿童相同程度的益处。方法：我们在四个儿科急诊科进行了双盲试验，其中720名患有轻度哮喘的儿童随机分为两组，一组口服地塞米松(每公斤体重0.6 mg)，另一组口服安慰剂。这些儿童有轻度的咽喉炎，根据Westley等人的咽喉评分系统的评分小于或等于2来定义。主要结果是在治疗后七天内因咳嗽回到医疗保健提供者那里。次要结果是在治疗后第1、2和3天出现持续的咽喉炎症状。其他结果包括经济成本、孩子失去的睡眠时间以及父母对孩子疾病的压力。结果：两组患者的基线临床特征相似。地塞米松组的回复率显著低于对照组(7.3%vs.15.3%，P
Background: The benefits of dexamethasone treatment for moderate-to-severe croup are well established. However, most children with croup have mild symptoms, and it is unknown whether they would derive the same degree of benefit from dexamethasone treatment as children with more severe disease.Methods: We conducted a double-blind trial at four pediatric emergency departments in which 720 children with mild croup were randomly assigned to receive one oral dose of either dexamethasone (0.6 mg per kilogram of body weight) or placebo. The children had mild croup, as defined by a score of less than or equal to2 on the croup scoring system of Westley et al. The primary outcome was a return to a medical care provider for croup within seven days after treatment. The secondary outcome was the presence of ongoing symptoms of croup on days 1, 2, and 3 after treatment. Other outcomes included economic costs, hours of sleep lost by the child, and stress on the part of the parent in relation to the child's illness.Results: Baseline clinical characteristics were similar in the two groups. Return to medical care was significantly lower in the dexamethasone group (7.3 percent vs. 15.3 percent, P