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Aerosolized racemic epinephrine, composed of equal amounts of the D- and L-isomers of epinephrine, is effective in treating croup. Because the D-isomer is essentially inactive, this randomized study examined whether the naturally occurring, widely available, and far less expensive L-form of epinephrine is as safe and effective as the racemic form.
Children aged six months to six years with moderate to severe croup received aerosolized epinephrine in either the racemic form (16 children) or the L-form (14 children). Pretreatment characteristics were similar in the two groups. Both forms of epinephrine caused significant transient improvement in the children, with no significant difference between the groups over time. Similarly, there were no…