Two New My Plans: Croup & Thrush

I have built My Plans for CROUP & THRUSH.
I used Up to Date for treatment options.

For CROUP they are now recommending Dexamethasone

• a one time oral dose (0.6mg/kg - max 10 mg), if giving a steroid. 
• I did include prednisolone 2mg/kg daily x 3 days as an alternative.

Note: They also said that Budesonide - 2mg by updraft x 1 was an alternative way to give the steroid. We do not have Budesonide here at the office. Do you think it would be worth ordering some? It might be a good option for those kids who refuse po meds or are vomiting. Of course you can always give IM dexamethasone.


The THRUSH My Plan is pretty straight forward. Nystatin is still the med of choice though some studies have suggested higher cure rates with higher doses.

• I have 2 doses listed: 1 ml ( 100,000 ux/ml) in each cheek 4 X / day (200,000 ux/dose QID ) or
• 2 ml in each cheek 4 times per day(400,000 ux/dose QID) for those kids not responding to lower dose. 
• I also have included fluconazole for nystatin failure & clotrimazole lozenges for older kids (> 4 years due to choking hazard).

Let me know what you think.