Introduction Croup is a common viral disease in children under 6 years old with incidence rate of 2–6%. The mainstay of treatment is airway management. Treatment focuses on respiratory distress, using cold mist, epinephrine, heliox and corticosteroids. In this study we tried compare the effectiveness of fluticasone spray with intramuscular dexamethasone.

Materials and Methods In this clinical trial, 107 children with croup were randomly assigned into two groups. The study group was treated by fluticasone propionate and the control group was treated by intramuscular dexamethasone. Croup scoring was performed at the 6th and 12th hours from initial administration according to Westley croup score.

Results Improvement was observed in 83% of the study group and 66% of the control group, 6 hours after initiation of treatment. In both groups 10% of the patients didn’t respond to treatment (p = 0.03).

12 hours after treatment the study group response was 85% and the control group response was 90% (p = 0.4)

Conclusion We found that fluticasone propionate and dexamethasone have similar efficacy in treatment of respiratory distress; considering the simple method of using fluticasone spray, it can be suggested as a good treatment for croup.