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Medication use in infants admitted with bronchiolitis

Ed Oakley1,2,3, Trusha Brys1, Meredith Borland4,5

  • 1Department of Emergency Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Emergency Medicine Australasia : EMA
|March 25, 2018
PubMed

Insights

Infants with bronchiolitis frequently receive varied medications, with use increasing with age. Evidence-based strategies are needed to improve medication practices for this common childhood illness.

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.
Abstract

Keywords:
antibioticsbronchiolitismedicationsalbutamolsteroids

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