[Infant bronchiolitis point of care by physicians in the Ile-de-France bronchiolitis network].
OBJECTIVE
The Ile-de-France bronchiolitis network assessment gave us the opportunity to carry out a survey regarding the customary handling of acute bronchiolitis by physicians involved in this network. The aim of this study was to retrieve results relating to season 2003-2004 and to compare them with the September 2000 French consensus conference recommendations.


METHODS
The practitioners engaged using a special form subsequently transmitted to network joint committee collected the clinical and therapeutic data of the patients included in the Network. We analysed 342 exploitable forms.


RESULTS
Analysis of the physicians medications for patients classified as bronchiolitis showed that their behavior was on the whole keeping with the official recommendations. The nearly systematic prescription of specific respiratory physiotherapy (increase in expiratory flow) satisfies the expectations of the French consensus conference. Likewise, treatments such as bronchodilator or corticoids that are not recommended were prescribed only in approximately 1/4 of cases. Abstention from all medical treatment was found in only 41% of cases classified as bronchiolitis. However, in considering only the first episode of acute bronchiolitis, this rate increased to 54,3%. Short-acting bronchodilator usage may appear legitimate as a therapeutic test of reversibility. In our study, 1/3 of patients with bronchiolitis treated by bronchodilator underwent a second episode and 80% of them were older than 6 months.


CONCLUSIONS
Analysis of the practices of physicians participating in the Bronchiolite Ile-de-France Network proves very positive in light of the comparison with studies prior and subsequent to the consensus conference. In recognition of this, it is necessary to consider the importance of the network's training programs. Beyond the need to go on with the diffusion of the recommendations, it seems desirable to extend them to clinical situations not yet considered, especially recurrent bronchiolitis and infant asthma. Finally, this type of study should be repeated in order to measure the future evolution of medical practices, as well as extended to a larger scope than the Ile-de-France bronchiolitis Network.
Sebban
S
S
Service de Rééducation Fonctionnelle, Coordination du Réseau Bronchiolite Ile-de-france, Association des Réseaux Bronchiolite, Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Paris, France. sydney.sebban@free.fr
Grimprel
E
E
Bray
J
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001988:Bronchiolitis / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002675:Child, Preschool; D019058:Community Networks; D004363:Drug Utilization; D005260:Female; D005602:France; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012138:Respiratory Therapy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents