International Delphi Consensus Issued on Pediatric Recurrent Croup

An international modified Delphi panel developed consensus-based recommendations for evaluating and managing pediatric recurrent croup, following a review of 28 studies that found substantial heterogeneity and moderate to high risk of bias in existing literature. The panel reached strong consensus on prioritizing direct laryngoscopy and bronchoscopy with subglottic sizing and laryngeal cleft exclusion in atypical presentations, limiting allergy testing to cases with clinical suspicion of atopy, and supporting shared otolaryngology-respiratory management while avoiding routine imaging. The panel did not reach consensus on empirical inhaled corticosteroids or antireflux therapy, which the authors identify as priorities for future research.

Most relevant for: Clinicians involved in the diagnostic workup and management of children with recurrent or atypical croup presentations.

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