Bronchiolitis in children: summary of NICE guidance

Bronchiolitis is the most common lower respiratory tract infection in the first year of life: one in five infants is affected and 2-3% are admitted to hospital.1 The diagnosis is made on clinical evidence and clinicians need to be confident with their decision. An initial coryzal illness progresses over three to five days to troublesome cough, increased work of breathing, and difficulty feeding. Mild cases can be managed at home, but infants with severe respiratory distress, difficulty taking adequate oral fluids, or with apnoea require secondary care. There are no effective treatments and hospitals provide supportive care with oxygen and hydration. Parents should be told about red flag symptoms that need prompt clinical review and should be aware that symptoms (mostly cough) may persist for weeks after the acute illness.2

This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on how to diagnose and manage infants and children with bronchiolitis.3