[Acute bronchiolitis: evaluation of evidence-based therapy]

Area of Science:

• Pediatrics
• Infectious Diseases
• Respiratory Medicine

Context:

• Bronchiolitis is a primary cause of infant lower respiratory tract infections, leading to substantial morbidity.
• Current treatment approaches for bronchiolitis are often controversial and lack robust evidence-based guidelines.
• Acute bronchiolitis, specifically the first episode in infants due to respiratory syncytial virus, is the focus of this review.

Purpose:

• To critically review available data on acute bronchiolitis treatment using evidence-based methodology.
• To identify justifiable and evidence-supported therapeutic interventions for infants with acute bronchiolitis.
• To highlight therapies requiring further investigation through randomized controlled trials.

Summary:

• Supportive treatment, nebulized epinephrine, and mechanical ventilation are the only evidence-based interventions for acute bronchiolitis.
• Physiotherapy, heliox, anticholinergics, and surfactant therapy require further randomized controlled trials for efficacy.
• Corticosteroids, beta-adrenergic drugs, antibiotics, and other non-supported therapies lack evidence for routine use in acute bronchiolitis.

Impact:

• This review clarifies the limited evidence-based treatment options for acute bronchiolitis in infants.
• It emphasizes the need for further research to establish effective therapies beyond supportive care.
• The findings support the development of national consensus guidelines for evidence-based clinical practice in managing acute bronchiolitis.