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Corticosteroid — Croup / Bacterial Meningitis / Post-Extubation Stridor / Cerebral Oedema

Dexamethasone (Paediatric)

Brand names: Dexsol, Ozurdex (ophthalmic)

Dexamethasone is a potent long-acting corticosteroid used in children for croup, as an antiemetic, in some malignancies, and to reduce inflammation or cerebral oedema.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds glucocorticoid receptors to modulate gene transcription, producing broad anti-inflammatory and immunosuppressive effects with minimal mineralocorticoid activity.

Prescribing in practice

  • Prolonged or repeated courses suppress the hypothalamic-pituitary-adrenal axis and can impair growth, so use the shortest effective course and never stop abruptly after extended treatment.
  • It increases susceptibility to infection and can mask its signs; exposure to chickenpox or measles in a non-immune child on systemic steroids needs prompt assessment.
  • Dose using a children's formulary; a single oral dose is standard for croup and live vaccines should be avoided during significant immunosuppression.

Monitoring

On longer-term use monitor growth, blood pressure, blood glucose and for signs of infection or adrenal suppression.

Counselling the patient

  • Do not stop a prolonged course suddenly and carry a steroid alert card if advised.
  • Report contact with chickenpox or measles and any signs of infection promptly.
  • For croup, improvement is usually seen within hours of the single dose.

Evidence & guidelines

Trials and NICE guidance support a single dose of dexamethasone for croup, reducing symptom severity and the need for re-attendance.

Reference: NICE CG102 (Bacterial Meningitis); Russell AS et al. BMJ 2011 (Croup Dexamethasone); BTS Croup Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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