Unfortunately, this is still probably not the trial that convinces everyone. In fact, it’s been over 15 years since the original single-center trials/reports showing that 0.15mg/kg of dexamethasone was every bit as effective as 0.6mg/kg of dexamethasone. This makes intuitive sense, considering the steroid equivalencies, and the doses used in studies that have established prednisolone as an adequate treatment for croup, as well.
Regardless, this is a very small – 30-odd patients – with mild croup, randomized to dexamethasone at 0.15mg/kg vs. placebo. The point of this study was not to test the efficacy of dexamethasone, but rather to show that, despite it’s long half-life, it had immediate effects. And, I think it’s fair to say this study demonstrates those significant effects in reduction in croup score, gaining statistical significance by 30 minutes.
I don’t know where the attachment came from in terms of the 0.6mg/kg dose of dexamethasone, but it’s just preposterously high.
“How fast does oral dexamethasone work in mild to moderately severe croup? A randomized double-blinded clinical trial.”
http://www.ncbi.nlm.nih.gov/pubmed/22313564