title: Management of bronchiolitis: current practices in Ireland.
abstract: To establish current practice for hospital-based treatment of uncomplicated respiratory syncytial virus (RSV) infection in the Republic of Ireland. A questionnaire was sent to all consultant general paediatricians in the Republic of Ireland. The questionnaire described a clinical scenario and this was followed by a list of management questions. The scenario was of a 3-month-old infant with uncomplicated but moderately severe RSV infection requiring hospitalization. Seventy-three questionnaires were sent. 63/73 (86%) of the questionnaires were returned. With respect to management of this case almost all (61/63) the paediatricians felt that oxygen therapy was necessary (oxygen saturation described in the case was 90%). With respect to bronchodilator therapy, ipratropium bromide (38/63--60%) was chosen much more frequently than salbutamol (15/63--24%). Chest physiotherapy would have been prescribed by 8/63--13% of paediatricians. Oral steroids were infrequently chosen (1/63--2%) but nebulised steroids were selected in 7/63 (11%) cases. The routine use of RSV monoclonal antibody, palivizumab, for RSV prophylaxis was reported by 49% (31/63) of paediatricians. Prematurity with bronchopulmonary dysplasia was considered an indication for its administration by all of these but only 23% considered prematurity alone to be an indication. The management of infants with RSV bronchiolitis varies greatly among consultant paediatricians in Ireland. Evidence based guidelines may be of value in establishing a more uniform national treatment approach.
authors.affiliation: National University of Ireland, Galway.
authors.forename: P
authors.initials: P
authors.lastname: Cahill
authors.forename: E
authors.initials: E
authors.lastname: Finan
authors.forename: B G
authors.initials: BG
authors.lastname: Loftus
mesh_terms: D000420:Albuterol / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000008:administration & dosage; D001988:Bronchiolitis / Q000628:therapy* / Q000821:virology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004837:Epinephrine / Q000008:administration & dosage; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D009241:Ipratropium / Q000627:therapeutic use; D007494:Ireland; D010102:Oxygen Inhalation Therapy; D000069455:Palivizumab; D010372:Pediatrics; D026761:Physical Therapy Specialty; D010820:Physicians; D018357:Respiratory Syncytial Virus Infections; D012136:Respiratory Syncytial Viruses; D013256:Steroids; D011795:Surveys and Questionnaires
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D001993:Bronchodilator Agents; D013256:Steroids; D000069455:Palivizumab; D009241:Ipratropium; D000420:Albuterol; D004837:Epinephrine