title: Recent evidence on the management of bronchiolitis.
abstract: OBJECTIVE
  Bronchiolitis is a common condition in children less than 2  years of age and is a leading cause of infant hospitalization. Although there is significant variability in testing and treatment of children with bronchiolitis, diagnostic testing rarely improves care, and no currently available pharmacologic options have been proven to provide meaningful benefits or improve outcomes.
  
  
  RESULTS
  Beta-agonists continue to be used frequently despite evidence that they do not reduce hospital admissions or length of stay. In general, therapies initially considered promising were subsequently proven ineffective, a pattern seen in studies on corticosteroids, and more recently with nebulized racemic epinephrine and hypertonic saline. Recent research has improved our understanding of the viral epidemiology of bronchiolitis, with increasing recognition of viruses other than respiratory syncytial virus and better awareness of the role of viral coinfections. How these findings will translate into improved outcomes remains uncertain.
  
  
  CONCLUSIONS
  Much of the emphasis of the last few decades of bronchiolitis clinical care and research has centered on the identification and testing of novel therapies. Future quality improvement efforts should focus more on the limitation of unnecessary testing and treatments. Future research should include identification of subgroups of children with bronchiolitis that may benefit from focused clinical interventions.
authors.affiliation: aDepartment of Pediatrics, Santa Clara Valley Medical Center, San Jose, California bDepartment of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Schroeder
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Mansbach
mesh_terms: D001988:Bronchiolitis / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004837:Epinephrine / Q000627:therapeutic use; D005938:Glucocorticoids; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy* / Q000503:physiopathology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D012462:Saline Solution, Hypertonic; D004837:Epinephrine
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