{ "schema_version": 1, "kind": "condition", "id": "croup", "name": "Acute croup (laryngotracheobronchitis)", "category": "infectious", "sources": "WHO Pocket Book of Hospital Care for Children 2013 · Egyptian National Drug Formulary - Endocrine System 2024 (dexamethasone monograph) · Budesonide 0.5 mg nebuliser suspension SmPC section 4.2 (eMC product 100358) · Croup - disease-level clinical article (croup-full.txt)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Endocrine System 2024 (dexamethasone monograph) · Budesonide 0.5 mg nebuliser suspension SmPC section 4.2 (eMC product 100358) · Croup - disease-level clinical article (croup-clinical.txt) · Croup - disease-level clinical article (croup-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 547, "generic": "Dexamethasone", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": 0.5, "adult_dose": "Not applicable — croup is an exclusively paediatric condition (see paediatric weight-based dosing)", "adult_duration": "Single dose", "dose_source": "Croup - disease-level clinical article (croup-full.txt): \"Dexamethasone doses of 0.15, 0.3, or 0.6 mg/kg appear equally effective; 0.6 mg/kg is the most commonly used dose.\" The Egyptian formulary dexamethasone entry carries no croup indication and no paediatric mg/kg dosing. The 12 mg per-dose ceiling is not stated in this article.", "rationale": "Single-dose oral corticosteroid dramatically reduces airway edema and hospital admission", "cautions": [ "Give single dose immediately upon presentation.", "Re-evaluate child within 1-2 hours; refer if stridor at rest persists.", "Caution in active varicella or systemic fungal infection." ], "peds_mgkg_low": 0.15, "peds_mgkg_high": 0.6, "peds_max_mg": 12.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "0.15 mg/kg single oral dose (or 0.6 mg/kg in severe croup; max 12 mg)", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 1.5, "high_mg": 6, "capped": false }, { "weight_kg": 20, "low_mg": 3, "high_mg": 12, "capped": false }, { "weight_kg": 30, "low_mg": 4.5, "high_mg": 12, "capped": true }, { "weight_kg": 40, "low_mg": 6, "high_mg": 12, "capped": true } ], "brands": [ { "trade_name": "DEXAMETHASONE 0.1MG/ML SYP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DELTASONE 0.25MG/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 30.0, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ORAZONE 0.1MG/ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 36.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "croup" }, { "id": 548, "generic": "Budesonide", "line": 1, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 1.0, "adult_dose": "2 mg single dose via jet nebulizer (alternative to oral dexamethasone)", "adult_duration": "Dosing can be repeated every 12 hour for a maximum of 36 hours or until clinical improvement.", "dose_source": "Budesonide 0.5 mg nebuliser suspension SmPC section 4.2 (eMC product 100358)", "rationale": "Nebulized corticosteroid alternative when oral route is refused or vomited", "cautions": [ "Use jet nebulizer with face mask.", "Refer to hospital if respiratory distress, chest indrawing, or cyanosis present.", "Rinse mouth/face after nebulization if possible.", "2 mg may be given as one dose or split into two 1 mg doses 30 minutes apart, and repeated every 12 hours for up to 36 hours or until the child improves." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "2 mg (=2000 mcg) single nebulized dose via face mask regardless of age/weight", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "BUDELIZER 1 MG/2ML 20 SUSP. AMP. FOR INH.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA > EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 106.5, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUNGOCORT 1 MG/2ML 20 SUSP. AMP. FOR INH.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 408.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BUDEXAN 1 MG/2ML 20 SUSP. AMP. FOR INH.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GENETIC S.P.A > AMRIYA", "price_egp": 529.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "croup" }, { "id": 549, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Croup - disease-level clinical article (croup-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Parent and caregiver warning signs require immediate emergency evaluation.", "RED FLAG - Admission or extended observation is needed for severe croup or symptoms persisting after 2+ epinephrine doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "croup" }, { "id": 550, "generic": "Oxygen", "line": 1, "is_adjunct": true, "form": null, "strength_mg": null, "adult_dose": "Not applicable - croup is a paediatric condition (see paediatric dosing)", "adult_duration": null, "dose_source": "Croup - disease-level clinical article (croup-full.txt)", "rationale": "Severe croup is an airway emergency and the article gives oxygen to every child whose saturation has fallen. It states no flow rate and no target saturation, so the article's own wording is printed rather than a number invented for it. No Egyptian product corresponds to it, which the physician ruled acceptable on 2026-08-16.", "cautions": [ "Any agitation can worsen the symptoms - do not force a mask or nasal cannula on a distressed child; blow-by administration may be more effective.", "Oxygen treats the hypoxia, not the airway obstruction: a child in the moderate or severe range needs prompt treatment aimed at the obstruction itself - racemic epinephrine, a steroid, supportive care, and oxygen only as required.", "A child needing oxygen for croup needs hospital care - moderate-to-severe cases require observation and admission if the symptoms do not improve." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Any child whose oxygen saturation has fallen is given supplemental oxygen. The article states no flow rate and no target saturation. It does say how to give it: keep the delivery as undisturbing as it can be made, because agitating a child with croup worsens the obstruction, and holding the source near the face - blow-by - may work better than strapping on a mask or nasal cannula.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "croup" }, { "id": 551, "generic": "Adrenaline", "line": 1, "is_adjunct": true, "form": "injection", "strength_mg": 1.0, "adult_dose": "Not applicable - croup is a paediatric condition (see paediatric dosing)", "adult_duration": null, "dose_source": "Croup - disease-level clinical article (croup-full.txt)", "rationale": "The card carried dexamethasone, budesonide and oxygen but nothing for the child who is actually struggling. The condition's own article names the drug and gives the amount in the same document: a child with moderate or severe croup receives nebulised epinephrine alongside dexamethasone, and the amount is about 0.5 mL/kg by nebuliser, of the L- form at 1:1000 strength. At 2 hours it outperforms racemic epinephrine, because its effect lasts longer. Named Adrenaline because that is the Egyptian register's spelling; the 1 mg/mL ampoule is the 1:1000 solution the article specifies.", "cautions": [ "HOSPITAL OR OBSERVED SETTING ONLY. On the article's account, nebulised racemic epinephrine improves the symptom score within 30 minutes, but in moderate-to-severe croup the effect can fade by 2 hours, so the child must be watched for a prolonged period afterwards. Where the improvement holds, discharge home is possible after 4 hours of observation and instructions to follow up closely. A child nebulised and sent straight home can rebound.", "Given WITH dexamethasone, not instead of it - the article pairs them for moderate-to-severe croup.", "Keep the child calm - the article asks for the least invasive route of giving a drug in croup, because agitation of any kind makes the symptoms worse. (Croup - StatPearls - NCBI Bookshelf, NBK431070)", "The Egyptian formulary's adrenaline monograph covers anaphylaxis, shock, cardiopulmonary resuscitation and bradycardia, not nebulisation for croup, and it states positively that where the situation is life-threatening there is no absolute contraindication to giving epinephrine at all. The croup dose and route above come from the disease article, not from that monograph.", "Watch for tachycardia, tremor, pallor and hypertension after the dose." ], "peds_mgkg_low": 0.5, "peds_mgkg_high": 0.5, "peds_max_mg": null, "peds_basis": "dose", "peds_unit": "mL", "peds_note": "Approximately 0.5 mL/kg of L-epinephrine 1:1000 (the 1 mg/mL ampoule) by nebuliser, for moderate-to-severe croup. The article states no maximum volume and no maximum number of doses, so none is given here; do not invent one.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 5, "high_mg": 5, "capped": false }, { "weight_kg": 20, "low_mg": 10, "high_mg": 10, "capped": false }, { "weight_kg": 30, "low_mg": 15, "high_mg": 15, "capped": false }, { "weight_kg": 40, "low_mg": 20, "high_mg": 20, "capped": false } ], "brands": [ { "trade_name": "EPINEPHRINE-MEMPHIS 1 MG/ML 5 I.M./S.C. AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADRENAMAX 1 MG/1ML 10 AMPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 75.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPINEPHRINE-MISR 1 MG/ML 100 AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 750.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADRENALINE-CID 1 MG/1ML 100 I.M./S.C. AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 850.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "croup" } ] }