About this Calculator

The Croup Dexamethasone Dose Calculator is a clinical tool designed to help healthcare professionals determine the appropriate single oral dose of dexamethasone for pediatric patients with laryngotracheobronchitis (croup). It bases its calculation on the patient's weight and the available drug concentration, adhering to widely accepted clinical guidelines.

Outputs Explained

After you input the patient's information, the calculator provides two key results:

• Final Dose (mg): This is the total amount of dexamethasone, in milligrams, to be administered. The calculation is based on a standard 0.6 mg/kg regimen, capped at a maximum of 16 mg.
• Administer (mL): This is the volume of the selected dexamethasone solution to draw up for oral administration. This value is derived from the final dose and the concentration you provide.

How to Use the Calculator

Follow these simple steps to determine the correct dosage:

1. Enter Patient Weight: Input the child's weight. You can toggle between kilograms (kg) and pounds (lbs).
2. Select Drug Concentration: Choose the concentration of the dexamethasone oral solution available to you from the dropdown menu. Common formulations are pre-listed.
3. Provide Custom Concentration (if needed): If your available concentration is not listed, select "Other..." and enter the specific concentration in mg/mL in the new field that appears.
4. Review Results: The calculator will instantly display the recommended dose in mg and the volume to administer in mL. Always verify the calculation before administration.

Dosing Overview

The standard dosing for dexamethasone in pediatric croup, regardless of severity, is a single oral dose of 0.6 mg per kilogram of body weight. To prevent excessive dosing in larger children, this calculator applies a maximum single dose of 16 mg. This one-time dose is typically sufficient to reduce airway inflammation and relieve symptoms. While other dosing regimens (e.g., 0.15 mg/kg) have been studied, the 0.6 mg/kg dose is associated with better outcomes and fewer return visits to the emergency department.

Switching Corticosteroids

This calculator is specifically for a single, one-time dose of dexamethasone for acute croup. In this clinical context, switching between different corticosteroids is not standard practice. Dexamethasone is preferred due to its long half-life and proven efficacy. If an alternative is needed (e.g., nebulized budesonide), it should be done under the direction of a physician based on the specific clinical scenario.

Missed or Vomited Dose

As croup treatment involves a single dose administered in a supervised setting, a "missed dose" is unlikely. If the child vomits within 30 minutes of administration, the dose should typically be re-administered. If vomiting occurs after 30 minutes, consult with the prescribing physician, as a significant portion of the medication may have already been absorbed. Do not administer a second dose without medical advice.

Safety Alerts

Frequently Asked Questions

Why is the maximum dose capped at 16 mg?

The 16 mg cap is a widely accepted practice to prevent potentially excessive steroid exposure in heavier children while still providing a potent anti-inflammatory effect. Most clinical guidelines and studies for croup endorse this maximum dose.

Can I use the injectable form of dexamethasone orally?

Yes, it is common practice to administer the injectable formulation of dexamethasone orally, particularly in hospital settings. It is effective and often more palatable than the oral solution. Ensure you select the correct concentration (e.g., 4 mg/mL or 10 mg/mL) in the calculator.

What should I do if the child's symptoms don't improve after the dose?

Dexamethasone typically begins to work within a few hours. If symptoms persist or worsen (e.g., increased work of breathing, stridor at rest, cyanosis), immediate medical re-evaluation is necessary.

Is this calculator suitable for adults with similar symptoms?

No. This calculator is calibrated for pediatric dosing of croup, a condition primarily affecting children. Adult dosing for upper airway inflammation would follow different guidelines.

How accurate is the weight conversion from lbs to kg?

The calculator uses the standard conversion factor of 1 kilogram = 2.20462 pounds for its calculations to ensure accuracy.

Why does the tool allow for an "Other" concentration?

This feature provides flexibility for healthcare settings that may use different or compounded formulations of dexamethasone not listed in the standard options.

Can I give a second dose the next day?

Routine repeat dosing is not standard practice for croup. Dexamethasone's long half-life means a single dose is usually sufficient. A repeat dose should only be given under the explicit direction of a healthcare provider.

Why is 0.6 mg/kg the standard dose for all severities of croup?

Clinical evidence has shown that the 0.6 mg/kg dose is effective for mild, moderate, and severe croup and is associated with a lower rate of return visits compared to lower doses. This simplifies the treatment protocol in a busy clinical setting.

References

The dosing regimen and clinical information presented are based on established medical literature and clinical guidelines. For further reading, please consult the following high-authority sources:

• Bjornson, C. L., & Johnson, D. W. (2013). Croup in children. Canadian Medical Association Journal, 185(15), 1317–1323. View on PubMed Central
• Roosevelt, G. E. (2023). Croup: Approach to management. In UpToDate. Retrieved from uptodate.com
• U.S. Food and Drug Administration. Dexamethasone Prescribing Information. Search FDA Drug Labels
• Royal Children's Hospital Melbourne. Clinical Practice Guidelines: Croup. View Guideline