Should systemic corticosteroids be used for bronchiolitis?

Alarcón-Andrade, Gonzalo; Cifuentes, Lorena

doi:10.5867/medwave.2018.03.7206

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…In our study, 95.35% of the patients received either corticosteroids, antibiotics, or salbutamol nebulization, translating into poor adherence to management guidelines in only 4.65% of cases. Despite the fact that several authors [ 52 , 53 ] and expert societies [ 14 , 20 ] have reported that corticosteroids have no added benefits in the management of acute bronchiolitis, it was administered in more than 70% of patients in this study. According to an Italian study, four out of ten paediatricians are aware of recommended diagnostic criteria for acute bronchiolitis, however, 39.64% still prescribe bronchodilators, while 64.52% prescribe systemic corticosteroids [ 54 ].…”

Section: Discussionmentioning

confidence: 95%

Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1–24 months with acute bronchiolitis in Douala, Cameroon

Eposse Ekoube,

Heles Nsang,

Épée

et al. 2024

BMC Pediatr

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Introduction In Cameroon, acute bronchiolitis has been reported as the third commonest lower respiratory infection and is usually associated with low mortality. Nonetheless, respiratory distress associated with non-adherence to management guidelines can prolong hospital stay. This study aimed to explore predictors of prolonged hospital stay (≥ 5 days) and mortality in patients aged < 2years hospitalised for acute bronchiolitis. Methodology We conducted a retrospective cohort study at three paediatric units in the city of Douala, Cameroon. Factors associated with prolonged hospital stay and mortality were determined using multivariable linear regression model. Threshold for significance was set at p ≤ 0.05. Results A total of 215 patients with bronchiolitis were included with mean age of 6.94 ± 5.71 months and M/F sex ratio of 1.39/1. Prolonged hospital stay was reported in 46.98% and mortality in 10.70% of patients hospitalised for bronchiolitis. Factors independently associated with prolonged hospital duration were oxygen administration [b = 0.36, OR = 2.35 (95% CI:1.16–4.74), p = 0.017], abnormal respiratory rate [b = 0.38, OR = 2.13 (1.00-4.55), p = 0.050] and patients presenting with cough [b = 0.33, OR = 2.35 (95% CI: 1.22–4.51), p = 0.011], and diarrhoea [b = 0.71, OR = 6.44 (95% CI: 1.6-25.86), p = 0.009] on admission. On the other hand, factors independently associated with mortality were age of the patient [b= -0.07, OR = 0.84 (95% CI: 0.74–0.97), p = 0.014] and oxygen administration [b = 1.08, OR = 9.64 (95% CI:1.16–79.85), p = 0.036] Conclusion Acute bronchiolitis represented 1.24% of admissions and was common in the rainy season, in males and 3–11-month-old patients. Management guidelines were poorly respected. Prolonged length of stay was reported in half of the patients hospitalized and mortality was high, especially in younger patients and in patients receiving oxygen.

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Section: Discussionmentioning

confidence: 95%

Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1–24 months with acute bronchiolitis in Douala, Cameroon

Eposse Ekoube,

Heles Nsang,

Épée

et al. 2024

BMC Pediatr

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Respiratory Syncytial Virus is the Most Common Causative Agent of Viral Bronchiolitis in Young Children: An Updated Review

Hon¹,

Leung

Wong

et al. 2023

CPR

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Background: Viral bronchiolitis is a common condition and a leading cause of hospitalization in young children. Objective: This article provides readers with an update on the evaluation, diagnosis, and treatment of viral bronchiolitis, primarily due to RSV Methods: A PubMed search was conducted in December 2021 in Clinical Queries using the key terms "acute bronchiolitis" OR “respiratory syncytial virus infection”. The search included clinical trials, randomized controlled trials, case control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to children and English literature. The information retrieved from the above search was used in the compilation of this article. Results: Respiratory syncytial virus (RSV) bronchiolitis is the most common viral bronchiolitis in young children. Other viruses such as human rhinovirus and coronavirus could be etiological agents. Diagnosis is based on clinical manifestation. Viral testing is useful only for cohort and quarantine purposes. Cochrane evidence-based reviews have been performed on most treatment modalities for RSV and various viral bronchiolitis. Treatment for viral bronchiolitis is mainly symptomatic support. Beta-agonists are frequently used despite the lack of evidence that they reduce hospital admissions or length of stay. Nebulized racemic epinephrine, hypertonic saline and corticosteroids are generally not effective. Passive immunoprophylaxis with a monoclonal antibody against RSV, when given intramuscularly and monthly during winter, is effective in preventing severe RSV bronchiolitis in high-risk children who are born prematurely and in children under 2 years with chronic lung disease or hemodynamically significant congenital heart disease. Vaccines for RSV bronchiolitis are being developed. Children with viral bronchiolitis in early life are at increased risk of developing asthma later in childhood Conclusions: Viral bronchiolitis is common. No current pharmacologic treatment or novel therapy has been proven to improve outcomes comparing to supportive treatment. Viral bronchiolitis in early life predisposes asthma development later in childhood

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Should systemic corticosteroids be used for bronchiolitis?

Abstract: We identified four systematic reviews, including 20 randomized trials overall. We concluded the use of systemic corticosteroids has no benefit for the treatment of bronchiolitis, even for patients with mechanical ventilation.

Cited by 2 publications

References 22 publications

Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1–24 months with acute bronchiolitis in Douala, Cameroon

Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1–24 months with acute bronchiolitis in Douala, Cameroon

Respiratory Syncytial Virus is the Most Common Causative Agent of Viral Bronchiolitis in Young Children: An Updated Review

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