Controversies in the treatment of bronchiolitis.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
Scarfone
Richard J
RJ
Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. Scarfone@email.chop.edu
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001988:Bronchiolitis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D004837:Epinephrine / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D004837:Epinephrine