Controversies in the treatment of bronchiolitis

Curr Opin Pediatr. 2005 Feb;17(1):62-6. doi: 10.1097/01.mop.0000149604.98591.9a.

Abstract

Purpose of review: Bronchiolitis is a very common and potentially serious respiratory disease of young children. To date, there is not a single, widely practiced, evidence-driven treatment approach. This review summarizes important recently published studies on the treatment of acute bronchiolitis for both outpatients and hospitalized children.

Recent findings: Bronchodilators, epinephrine, and corticosteroids have all been used in the treatment of bronchiolitis. As with older studies, most recently published randomized clinical trials have failed to demonstrate clinical efficacy in the use of these medications to treat either outpatients or infants hospitalized with bronchiolitis. Further, several meta-analyses and systematic reviews on this subject have been published in the last year or 2. Once again, most fail to provide convincing evidence to support the routine use of these medications to treat bronchiolitis.

Summary: The routine and repetitive use of bronchodilators, epinephrine, or corticosteroids to treat bronchiolitis in the absence of demonstrated clinical benefits for individual patients is not justified.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Bronchiolitis / drug therapy*
  • Bronchodilator Agents / therapeutic use*
  • Child
  • Epinephrine / therapeutic use*
  • Humans
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Bronchodilator Agents
  • Epinephrine