A 2-year-old child presents with a barking cough, inspiratory stridor, and mild respiratory distress that started suddenly at night. There is no drooling and the child is afebrile. What is the most appropriate first-line treatment?
- A Nebulized epinephrine
- B Intravenous antibiotics
- C Oral dexamethasone ✓
- D Heliox inhalation
Correct answer: C. Oral dexamethasone
Explanation
This child has croup (laryngotracheobronchitis). Oral dexamethasone (0.6 mg/kg) is the first-line treatment as it reduces airway edema and improves symptoms within hours. Nebulized epinephrine is reserved for severe stridor at rest. Antibiotics are not indicated as croup is viral. Heliox is used in severe refractory cases only.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.