[Current management of acute bronchiolitis in Tunisia]

The purpose of this study was to assess the current management practices of acute bronchiolitis by tunisian paediatricians.

A questionnaire was sent by mail to all tunisian paediatricians, about the most widely used drugs during the first stage of acute bronchiolitis. The answers were sent to us by mail in pre-stamped envelopes.

Out of total of 420 questionnaires sent, 180 (42.8%) were returned, out of which 177 (42%) were analysed. Of the respondents, 117 (66%) were working in hospitals and, 60 (34%) were working in the private sector. Bronchodilatators were used by 93.3% of peadiatricians either routinely (35.6%) or occasionally (44.1%). Steroids were used by 88.7% of pediatricians either routinely (28.8%) or occasionally (43.5%) Nasal drops, were prescribed routinely by 80.2% of the pediatricians. Physiotherapy was performed routinely or occasionally in 91.5% of the cases. Oygen and antibiotics were respectively used by 92% and 70% of the paediatricians. A comparaison between the practices of the hospital paediatricians and their private sector conterparts showed that private practitioners, statistically, prescribe more bronchodilatators (42.7% vs 21.7%) (p < 0.05) and corticosteroids (36.8% vs. 13.3%) (p < 0.05) than their hospital colleagues. Hospital physicians, more than the private sector ones, tend to never prescribe bronchodilatators ,2 (15% vs. 2.6%) (p < 0.05) and steroids (25% vs. 4.3) (p < 0.05).

Despite the absence of the scientific evidence showing a beneficial effect of the pharmaceutical agents, most paediatricians, during the initial phase of acute bronchiolitis, resort to prescribing bronchodilators (93.3%) and corticosteroids (88.7%). There is a great variety of therapeutic practices among hospital paediatricians and private practitioners. National guidelines could be helpful in reducing this disparity.