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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Treatment

• 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 were routinely recommended, studies have not proven these treatments to be effective.
• Steroid therapy has been shown to be of benefit in children with moderate to severe 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.