[Chest X-ray and acute bronchiolitis: Are these indications decreasing?]

Area of Science:

• Pediatrics
• Respiratory Medicine
• Diagnostic Imaging

Background:

• Acute bronchiolitis is a common respiratory infection in infants.
• Chest X-rays are recommended for bronchiolitis only when clinical course is unusual or differential diagnosis is suspected.
• A management protocol was implemented to guide X-ray use in 2012.

Purpose of the Study:

• To evaluate professional practices regarding chest X-ray use in infants hospitalized with acute bronchiolitis after protocol implementation.
• To assess adherence to the established management protocol for diagnostic imaging.

Main Methods:

• Retrospective descriptive study.
• Inclusion of infants aged 0-23 months hospitalized for their first acute bronchiolitis episode.
• Data collected from October 2013 to March 2015 across two pediatric units.

Main Results:

• 599 infants were included; 59.3% had at least one chest X-ray, a 38.5% decrease from 2012.
• X-rays were abnormal in 96.3% of cases, showing common findings like distension and thickening.
• 42.5% of X-rays were performed outside protocol recommendations, leading to increased antibiotic prescriptions for pneumonia.

Conclusions:

• The management protocol successfully decreased chest X-ray utilization in acute bronchiolitis.
• Suboptimal adherence to guidelines resulted in unnecessary X-rays and increased antibiotic use.
• Further efforts are needed to ensure appropriate diagnostic imaging and antibiotic stewardship in infant bronchiolitis management.