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A predictive model of inappropriate use of medical tests and medications in Bronchiolitis

Jefferson Antonio Buendía1,2,3, Carlos Andrés Rodríguez1,2,3

  • 1Grupo de Investigación en Farmacología y Toxicología (INFARTO), Universidad de Antioquia, Medellín, Colombia.

The Pan African Medical Journal
|January 11, 2021
PubMed

Insights

Inappropriate medication and test use in bronchiolitis is common. Longer hospital stays increase this risk, while fever and high white blood cell counts at admission decrease it.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Clinical Pharmacology

Background:

  • Bronchiolitis is a common respiratory infection in infants.
  • Inappropriate use of medications and diagnostic tests in bronchiolitis is a concern.
  • Predictors for this inappropriate use require further investigation.

Purpose of the Study:

  • To identify factors associated with the inappropriate use of medications and medical tests in infants hospitalized with bronchiolitis.
  • To analyze the prevalence of specific medications and tests prescribed during bronchiolitis admissions.

Main Methods:

  • Retrospective study of 1930 infants under two years old admitted with bronchiolitis (January 2015 - December 2018).
  • Defined a composite score for inappropriate medication and test use.
  • Statistical analysis controlled for potential confounders.

Main Results:

  • Nebulized hypertonic saline (92.6%), albuterol (56%), and antibiotics (26.4%) were frequently prescribed.
  • Hemogram (95.9%), chest X-rays (92.2%), and C-reactive protein (79.8%) were commonly ordered tests.
  • Longer hospital stay increased inappropriate use risk (OR 1.29). Absence of fever (OR 0.22) and leukocytosis (OR 0.09) decreased this risk.

Conclusions:

  • Inappropriate use of diagnostic tests and drugs for bronchiolitis is highly prevalent.
  • Factors increasing risk include longer hospitalizations.
  • Factors decreasing risk include absence of fever and normal white blood cell count upon admission.

Keywords:
BronchiolitisColombiacostresources

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