Racemic Epinephrine in Croup (continued)

We believe the article by Gardner et al., "The Evaluation of Racemic Epinephrine in the Treatment of Infectious Croup," in the July 1973 issue of Pediatrics deserves comment. In our paper, "Ten-Year Experience with IPPB in the Treatment of Acute Laryngotracheobronchitis," referred to by Gardner et al., we described a method which, in our hands, totally eliminated the necessity for tracheostomy in infectious croup, with no mortality. To date we have found it necessary to perform tracheostomies on two patients with croup, both of whom were subsequently found to have congenital tracheal stenosis necessitating long-term tracheotomies; otherwise the effectiveness of our regimen in the treatment of infectious croup remains unchanged (100%), now over a 13-year period.