Clinical Factors Associated with Inappropriate Antibiotic Use in Children with Acute Bronchiolitis

Area of Science:

• Pediatrics
• Infectious Diseases
• Pharmacology

Background:

• Acute bronchiolitis is a common pediatric respiratory illness, predominantly viral.
• Serious bacterial infections are rare in children with acute bronchiolitis.
• Antibiotic prescription is frequent despite the low incidence of bacterial infections.

Purpose of the Study:

• To identify clinical factors associated with inappropriate antibiotic use in children hospitalized with acute bronchiolitis.
• To analyze the drivers of antibiotic prescription in this pediatric population.

Main Methods:

• Retrospective review of medical records for 612 children (3-23 months) hospitalized with their first episode of acute bronchiolitis.
• Categorization into antibiotic and non-antibiotic groups based on admission prescription.
• Comparison of clinical variables to identify factors associated with antibiotic use.

Main Results:

• 84% of children received antibiotic therapy upon admission.
• Fever and C-reactive protein levels (≥0.50 mg/dL) were independently associated with inappropriate antibiotic use.
• The antibiotic group experienced a longer duration of fever post-admission.

Conclusions:

• The majority of children hospitalized with acute bronchiolitis receive antibiotics without clear clinical benefit or diagnostic justification.
• Fever and elevated C-reactive protein are primary, yet insufficient, indicators for antibiotic use in acute bronchiolitis.
• Reducing unnecessary antibiotic use in pediatric bronchiolitis requires addressing clinical decision-making based on these markers.