[Impact of the consensus conference on the ambulatory treatment of bronchiolitis in infants].
OBJECTIVE
To assess the impact of guidelines of the consensus conference in September 2000 on the ambulatory management of acute bronchiolitis in infants.


METHODS
Prospective multicenter study, in four hospitals in the North department in France, during three epidemic periods: the winter preceding the consensus conference and the two following winters. All the infants between 30 days and 2 years of age, admitted to an emergency care unit for a first or second episode of bronchiolitis were included. The infants' characteristics and ambulatory treatments prescribed were collected.


RESULTS
Six hundred thirty-eight infants were included: 169 before the conference and 469 after. Seventy-seven percent had consulted previously and a prescription had been drawn-up for 77%. There was no difference in the frequency of drug prescriptions or physiotherapy between the three periods. After the conferences, inhaled beta(2) agonists were still prescribed in 21% of cases, inhaled corticosteroids in 15%, oral corticosteroids in 34%, antibiotics in 53% and mucolytics in 54%. Physiotherapy was prescribed for 58% of the infants.


CONCLUSIONS
Two years after the consensus conference, the ambulatory treatment of bronchiolitis has no changed, corticosteroids, beta(2) agonists, antibiotics and mucolytics are still prescribed in excess. Further studies, within a few years, are required to reassess the application of the guidelines, not only in outpatient but also in inpatient management.
Halna
Muriel
M
Service d'accueil et de traitement des urgences, France.
Leblond
Pierre
P
Aissi
Euridyce
E
Dumonceaux
Anne
A
Delepoulle
Florence
F
El Kohen
Rachid
R
Hue
Valérie
V
Martinot
Alain
A
D000208:Acute Disease; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001988:Bronchiolitis / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D016009:Chi-Square Distribution; D032921:Consensus; D011307:Drug Prescriptions; D004630:Emergencies; D005100:Expectorants / Q000627:therapeutic use; D005602:France; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D012138:Respiratory Therapy / Q000379:methods
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000900:Anti-Bacterial Agents; D005100:Expectorants