title: [Management of bronchiolitis in general practice and determinants of treatment being discordant with guidelines of the HAS].
abstract: BACKGROUND
  The Haute autorité de santé released clinical practice guidelines in 2000 to assist in the management of bronchiolitis. These guidelines emphasized supportive care with nasal suctioning and encouraged chest physiotherapy. The aim of this study was to examine the adherence to the french guidelines for the management of bronchiolitis by general practitioners.
  
  
  METHODS
  The study included infants less than 24 months of age with bronchiolitis, consulting a general practitioner in Vendée or in Loire-Atlantique, from November 2011 to April 2012 and whose parents accepted to participate to the study. The primary endpoint was the concordance of therapeutic practice with the french guidelines (administrated treatments, refer to pediatric emergencies). Data were collected through questionaires completed by general practitioners.
  
  
  RESULTS
  Of the 1236 questionnaires distributed, 134 were completed and 118 therapeutic practice were analyzed. A total of 52.5% of therapeutic practice were concordant with guidelines and 57.5% in case of first bronchiolitis. 50% of infants with a hospitalization criteria according to the guidelines, have not been, which probably shows the interest of new guidelines, with highlighting of hospitalization criteria.
authors.affiliation: Urgences pédiatriques, hôpital mère-enfant, CHU de Nantes, 7, quai Moncousu, 44093 Nantes cedex 1, France. Electronic address: ebranchereau@hotmail.fr.
authors.forename: E
authors.initials: E
authors.lastname: Branchereau
authors.forename: B
authors.initials: B
authors.lastname: Branger
authors.forename: E
authors.initials: E
authors.lastname: Launay
authors.forename: M
authors.initials: M
authors.lastname: Verstraete
authors.forename: B
authors.initials: B
authors.lastname: Vrignaud
authors.forename: K
authors.initials: K
authors.lastname: Levieux
authors.forename: R
authors.initials: R
authors.lastname: Senand
authors.forename: C
authors.initials: C
authors.lastname: Gras-Le Guen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001988:Bronchiolitis / Q000188:drug therapy* / Q000628:therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005100:Expectorants / Q000627:therapeutic use*; D005602:France; D058006:General Practice; D005938:Glucocorticoids / Q000627:therapeutic use*; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D013396:Suction / Q000379:methods; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D005100:Expectorants; D005938:Glucocorticoids