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Pediatricians' Attitude in Management of Acute Bronchiolitis: Did Guidelines Overcome Practices?

Ayse Gultekingil1, Emre Gocer1, Murat Anil2

  • 1Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Pediatric Allergy, Immunology, and Pulmonology
|July 21, 2022
PubMed

Insights

Pediatricians frequently use unrecommended treatments like bronchodilators and steroids for acute bronchiolitis, despite updated clinical guidelines. This study highlights a gap between evidence-based practices and common clinical approaches for this common childhood illness.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Clinical Practice

Background:

  • Acute bronchiolitis is a leading cause of pediatric hospitalizations.
  • Recent guideline updates aim to standardize treatment protocols.
  • Variations in clinical practice may impact patient outcomes.

Purpose of the Study:

  • To assess current treatment strategies for acute bronchiolitis among clinicians.
  • To evaluate adherence to established clinical guidelines.
  • To identify common therapeutic interventions used in practice.

Main Methods:

  • Multicenter, cross-sectional, descriptive study design.
  • Survey questionnaire administered to pediatric residents, fellows, and attendings.
  • Data collected on clinician characteristics and treatment choices.

Main Results:

  • Inhaled salbutamol was the most frequently used treatment, followed by IV hydration and hypertonic saline.
  • Oral hydration was preferred for mild cases, while inhaled salbutamol was favored for severe cases.
  • A significant proportion of clinicians reported using therapies not supported by current guidelines, including bronchodilators, corticosteroids, and antibiotics.

Conclusions:

  • Despite guideline recommendations against many therapies, clinicians continue to use them for acute bronchiolitis.
  • Bronchodilators, corticosteroids, and antibiotics remain commonly employed despite limited evidence of efficacy.
  • Further education and guideline dissemination are needed to improve adherence to evidence-based treatment for acute bronchiolitis.

Keywords:
bronchiolitischildrenguidelineinfanttreatment

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