In Reply.—I agree with Lacroix and Massicotte that there are various differences in the design of the study by Massicotte and Tétreault1 as compared with ours.2 By including only severe cases, I believe that many of their patients with SC were excluded. This may explain the different results in the patients with SC as compared with our patients. However, unlike the interpretation of Lacroix and Massicotte, we have clearly shown that the patients with SC who received placebo did improve well. The rate of improvement was more favorable in the corticosteroid-treated group.
My colleagues and I have stated that one should be careful in extrapolating the six-hour data into the full course of the croup attack. However, we believe that in studying a disease that, in most cases, has a short course, one should try to achieve accurate information on the first critical hours, when most variables