What is the primary treatment for less severe cases of croup?

The primary treatment for less severe cases of croup involves the use of corticosteroids, which effectively reduce inflammation in the airways. While nebulized racemic epinephrine can be helpful in more severe cases where stridor is present at rest, it is not typically utilized in less severe instances. Instead, corticosteroids can be administered orally to help manage the symptoms associated with mild to moderate croup.

Nebulized saline can provide some symptomatic relief, but it is not considered a cornerstone treatment for croup. The key here is that for less severe cases, the focus is primarily on reducing airway inflammation with oral steroids, reserving nebulized treatments for more acute presentations.

In contrast, other treatment options like oral antihistamines and cough syrups are not effective for the underlying viral cause of croup and may not provide significant benefit. Intravenous antibiotics and high-flow oxygen are more suitable for settings involving severe bacterial infections or respiratory distress, not for croup, which is primarily viral. Bronchodilators, while sometimes considered for wheezing, do not address the primary issue of inflammation in croup. Thus, the best approach for less severe croup cases centers on the use of corticosteroids and careful observation.