The effectiveness of racemic epinephrine in the treatment of croup was evaluated by a retrospective review, a prospective protocol, and a controlled study. Although the majority of children who were treated with racemic epinephrine and evaluated prospectively had significant immediate clinical improvement, the therapeutic regimen did not seem to affect the overall duration of hospitalization or the incidence of tracheotomy during the study period. Ten of the 20 children who participated in the double-blind controlled study had significant improvement; five received racemic epinephrine and five received the placebo. These findings suggest that the apparent effectiveness of racemic epinephrine might be due to the nebulization of moisture rather than a direct effect of the drug.The present study points out the critical need for controlled studies in the evaluation of therapeutic procedures in the treatment of croup.
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