Bronchodilators use decreased in bronchiolitis in infants, abiding by AAP recommendations
Massachusetts: The use of bronchodilators decreased significantly from 2010 to 2018 for treatment of infants with bronchiolitis, reveals findings from a large study of infants at children's hospitals.
The study, published in the journal Pediatrics, supports the current recommendation of the American Academy of Pediatrics to limit routine use of bronchodilators for the treatment of infants with bronchiolitis.
Kristen H. Shanahan, Harvard University, Boston, Massachusetts, and colleagues aimed to characterize trends in and outcomes associated with the use of bronchodilators for bronchiolitis in a multicenter retrospective study of infants <12 months of age with bronchiolitis from 49 children's hospitals from 2010 to 2018.
The primary outcomes were rates of hospital admissions, ICU admissions, emergency department (ED) return visits after initial ED discharge, noninvasive ventilation, and invasive ventilation. The researchers used multivariable logistic regression to evaluate the rates of outcomes among hospitals with high and low early use of bronchodilators (on day of presentation).
The study included a total of 446 696 ED visits of infants with bronchiolitis.
Based on the findings, the researchers found that:
- Bronchodilator use, hospital admissions, and ED return visits decreased between 2010 and 2018.
- ICU admissions and invasive and noninvasive ventilation increased over the study period.
- Hospital-level early bronchodilator use (hospitals with high versus low use) was not associated with differences in patient-level hospital admissions, ICU admissions, ED return visits, noninvasive ventilation, or invasive ventilation.
"High hospital-level bronchodilator use is not associated with better outcomes; adjustment follows AAP recommendations to limit routine use for bronchiolitis," concluded the authors.
The study titled, "Early Use of Bronchodilators and Outcomes in Bronchiolitis," is published in the journal Pediatrics.