Rosh Emergency Medicine Practice Test 2025 - Free Emergency Medicine Practice Questions and Study Guide

The primary treatment for a child with croup is dexamethasone. Dexamethasone is a corticosteroid that helps reduce inflammation in the airways, which is a key issue in croup. This medication is effective in minimizing the symptoms related to airway swelling, thus improving the child's ability to breathe comfortably and alleviating stridor (the harsh, wheezing sound produced during breathing due to narrowed airways).

Croup is often caused by viral infections, leading to inflammation and narrowing of the upper airway. The use of dexamethasone has been shown to decrease the duration of symptoms as well as the need for other interventions, such as nebulized epinephrine, in moderate to severe cases.

While prednisone may also be effective as a treatment option for croup, dexamethasone is preferred because of its longer duration of action, more favorable dosing regimen, and ease of administration, often in a single dose compared to prednisone's multi-day regimen. The other choices, such as antihistamines or albuterol, while beneficial in different contexts, do not address the underlying inflammation causing croup and are not considered standard first-line treatments for this condition.