What Is the Treatment for Croup?
- Overall, the initial goal is to determine the severity of illness. This will guide the medical treatment. Although, in the past, humidified oxygen or cool mist treatments were routinely recommended, studies have not proven these treatments to be effective.
- Steroid therapy has been shown to be of benefit in all children with croup. It may be given orally, by injection, or by IV. Inhaled steroids appear to have limited value. Because most croup is caused by viral infections, antibiotics have not been shown to be beneficial in the treatment of croup.
- Nebulized epinephrine or racemic epinephrine may be administered to children with moderate or severe symptoms. Currently there is no evidence to support the use of racemic epinephrine over nebulized epinephrine.
- If your child responds to treatment, the doctor may elect to observe the child for an additional few hours to make sure the symptoms do not return after the medications have worn off. If your child remains symptomatic after therapy, then the child will require admission to the hospital.
What Is the Follow-up for Croup?
- Have the child rest as much as possible.
- Give him or her plenty of fluids to drink.
- Keep your child calm, because breathing symptoms can worsen with crying and agitation.
- Make certain your child takes his or her medications for the length of time prescribed, even if the child has improved.
- If symptoms return or worsen, then notify your doctor or return to the emergency department.
How Can You Prevent Croup?
Croup is a contagious disease. If possible, avoid contact with others who have colds or cough symptoms.
- Have children wash their hands often to reduce the chance of spreading the infection.
- Get prompt treatment with symptoms of respiratory infection.
- Increase the amount of fluids children drink.
- Avoid exposure to respiratory irritants such as smoke.
What Is the Prognosis for Croup?
Although most children with croup improve after 48 hours, there are some cases that will take longer to resolve. In a small number of cases, admission to a hospital for more intensive management may be required. Of those admitted, only 1%-2% will be severe enough to require a breathing tube with mechanical ventilation or pediatric intensive care.
Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics
Bjornson, C., and D. Johnson. "Croup." Lancet 2008; 371: 329–39
Bjornson C, and W. Johnson. "Croup in Children." CMAJ 185.15 (2013): 1317-1323.
Mazza, D., et al. "Evidence based guideline for the management of croup." Aust Fam Physician. 2008 Jun;37(6 Spec No):14-20.
Zoorob, R., M. Sidani, and J. Murray. "Croup: An Overview." Am Fam Physician 83.9 May 1, 2011: 1067-1073.
Medically Reviewed by a Doctor on 11/9/2016
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