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Current approaches to acute bronchiolitis management among pediatricians: guideline adherence and practice variation

Özlem Üzüm1, Gülberat Totur2, Kayı Eliaçık2

  • 1Dokuz Eylül Üniversity, Faculty of Medicine, Department of Pediatric Diseases, Izmir, Turkey. baspinarozlemm@hotmail.com.

BMC Pediatrics
|July 7, 2026
PubMed

Insights

Pediatricians show varied adherence to acute bronchiolitis guidelines. Factors like experience and using severity scores impact care, with non-recommended treatments still common, especially in severe cases.

Area of Science:

  • Pediatric Medicine
  • Clinical Practice Guidelines
  • Evidence-Based Medicine

Background:

  • Clinical guidelines recommend supportive care for acute bronchiolitis.
  • Significant variability exists in pediatricians' diagnostic and therapeutic practices.
  • Identifying factors influencing guideline adherence is crucial for improving care.

Purpose of the Study:

  • To identify factors associated with adherence to acute bronchiolitis clinical guidelines among pediatricians.
  • To assess the gap between evidence-based recommendations and real-world practices in bronchiolitis management.

Main Methods:

  • A cross-sectional study involving 239 pediatricians using a web-based questionnaire.
  • Data collected on demographics, use of severity scoring systems, and treatment preferences.
  • Participants categorized by guideline adherence and professional status (resident vs. specialist).

Main Results:

  • 59.8% of pediatricians adhered to at least one guideline; adherence was higher in residents and those using severity scores.
  • Oxygen and hydration were common; nebulized therapies and steroids increased with severity, despite limited guideline support.
  • Non-recommended therapies were frequently used, particularly in severe cases; guideline adherents favored supportive care.

Conclusions:

  • Variability in acute bronchiolitis management persists despite guidelines.
  • Disease severity, experience, and use of scoring systems influence adherence.
  • Targeted education can improve guideline implementation and promote high-value supportive care.
Abstract

Keywords:
Acute bronchiolitisGuideline adherencePediatriciansPractice variationSupportive care

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