Medication use in infants admitted with bronchiolitis

Area of Science:

• Pediatrics
• Respiratory Medicine
• Clinical Pharmacy

Background:

• No known medications improve outcomes for infants with bronchiolitis.
• Management of bronchiolitis shows significant variability in clinical practice.
• This study addresses the need for clarity on current medication use in bronchiolitis management.

Purpose of the Study:

• To describe and analyze medication utilization patterns in infants hospitalized with bronchiolitis.
• To investigate medication use across seven hospitals participating in the Comparative Rehydration in Bronchiolitis (CRIB) trial.
• To identify variations in medication administration based on patient age and intensive care unit (ICU) admission.

Main Methods:

• Retrospective analysis of data from 3456 infants (2-12 months corrected age) admitted with bronchiolitis.
• Data collected from the CRIB trial records, medical charts, and pathology/radiology databases.
• Investigated medications included salbutamol, adrenaline, steroids, ipratropium bromide, saline solutions, and antibiotics.

Main Results:

• 42% of infants received at least one medication during hospitalization, with site variation from 27% to 48.7%.
• Salbutamol was the most frequently used medication (25.5%).
• Medication use, particularly salbutamol, significantly increased with age (from 4 to 11 months) and was higher in ICU patients (81.6% vs. 39.5%).

Conclusions:

• Medication use in infants with bronchiolitis is frequent, variable, and increases with age in Australia and New Zealand.
• Current practices highlight a gap between evidence and clinical application.
• Improved strategies are necessary to translate evidence into consistent, effective clinical practice for bronchiolitis management.