This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (30)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Neonatology and Infant Care  • Alert me on articles by topic

A Systematic Review

Valerie J. King, MD, MPH; Meera Viswanathan, PhD; W. Clayton Bordley, MD, MPH; Anne M. Jackman, MSW; Sonya F. Sutton, BSPH; Kathleen N. Lohr, PhD; Timothy S. Carey, MD, MPH

Arch Pediatr Adolesc Med. 2004;158:127-137.

Background  Bronchiolitis is the most common lower respiratory tract infection in infants. Up to 3% of all children in their first year of life are hospitalized with bronchiolitis. Bronchodilators and corticosteroids are commonly used treatments, but little consensus exists about optimal management strategies.

Objective  To conduct a systematic review of the effectiveness of commonly used treatments for bronchiolitis in infants and children.

Data Sources  We searched MEDLINE and the Cochrane Controlled Trials Register for references to randomized controlled trials of bronchiolitis treatment published since 1980.

Study Selection  Randomized controlled trials of interventions for bronchiolitis in infants and children were included if they were published in English between 1980 and November 2002 and had a minimum sample size of 10.

Data Extraction  We abstracted data on characteristics of the study population, interventions used, and results of studies meeting entry criteria into evidence tables and analyzed them by drug category.

Data Synthesis  Interventions were grouped by drug category and qualitatively synthesized.

Results  Of 797 abstracts identified in the literature search, we included 54 randomized controlled trials. This review includes 44 studies of the most common interventions: epinephrine (n = 8), 2-agonist bronchodilators (n = 13), corticosteroids (n = 13), and ribavirin (n = 10). Studies were, in general, underpowered to detect statistically significant outcome differences between study groups. Few studies collected data on outcomes that are of great importance to parents and clinicians, such as the need for and duration of hospitalization.

Conclusions  Overall, little evidence supports a routine role for any of these drugs in treating patients with bronchiolitis. A sufficiently large, well-designed pragmatic trial of the commonly used interventions for bronchiolitis is needed to determine the most effective treatment strategies for managing this condition.

RELATED ARTICLES

Managing Bronchiolitis and Respiratory Syncytial Virus: Finding the Yellow Brick Road
Caroline Breese Hall
Arch Pediatr Adolesc Med. 2004;158(2):111-112.
EXTRACT | FULL TEXT  

Diagnosis and Testing in Bronchiolitis: A Systematic Review
W. Clayton Bordley, Meera Viswanathan, Valerie J. King, Sonya F. Sutton, Anne M. Jackman, Laura Sterling, and Kathleen N. Lohr
Arch Pediatr Adolesc Med. 2004;158(2):119-126.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Respiratory Viruses Other than Influenza Virus: Impact and Therapeutic Advances
Nichols et al.
Clin. Microbiol. Rev. 2008;21:274-290.
ABSTRACT | FULL TEXT  

Diagnosis and Management of Bronchiolitis
Subcommittee on Diagnosis and Management of Bronch
Pediatrics 2006;118:1774-1793.
ABSTRACT | FULL TEXT  

BRONCHIOLITIS
Meates-Dennis
EDUCATION AND PRACTICE 2005;90:ep81-ep86.
FULL TEXT  

Variability in the Management of Bronchiolitis in Children's Hospitals
Pate
AAP Grand Rounds 2005;14:20-21.
FULL TEXT  

Hospital Readmission for Bronchiolitis
Kemper et al.
CLIN PEDIATR 2005;44:509-513.
ABSTRACT  

Variation in Inpatient Diagnostic Testing and Management of Bronchiolitis
Christakis et al.
Pediatrics 2005;115:878-884.
ABSTRACT | FULL TEXT  

JournalScan
Wyatt and Slater
Emerg. Med. J. 2005;22:190-191.
FULL TEXT  

Towards evidence based medicine for paediatricians
Phillips
Arch. Dis. Child. 2005;90:319-319.
FULL TEXT  

Serious Bacterial Infections in RSV Admissions to the ICU
Pate
AAP Grand Rounds 2005;13:14-15.
FULL TEXT  

Do We Really Need More Trials About the Efficacy of Commonly Used Treatments for Bronchiolitis?
Barbi et al.
Arch Pediatr Adolesc Med 2005;159:196-197.
FULL TEXT  

Do We Really Need More Trials About the Efficacy of Commonly Used Treatments for Bronchiolitis?--Reply
King et al.
Arch Pediatr Adolesc Med 2005;159:197-197.
FULL TEXT  

Review: commonly used pharmacological treatments for bronchiolitis in children do not seem to be effective
Kellner
EDUCATION AND PRACTICE 2004;89:ep79-ep79.
FULL TEXT  

Review: commonly used pharmacological treatments for bronchiolitis in children do not seem to be effective
Kellner
Evid. Based Med. 2004;9:141-141.
FULL TEXT  

Other articles noted: 06 Feb 2004 to 16 Apr 2004
Evid. Based Nurs. 2004;7:e3-e3.
FULL TEXT  

Assessment of Pharmacologic Therapies and Diagnostic Tests for Viral Bronchiolitis: Drugs and Tests Appear to Be of No Value
Pate
AAP Grand Rounds 2004;12:3-4.
FULL TEXT  

Bronchiolitis
DiTraglia
Arch Pediatr Adolesc Med 2004;158:707-707.
FULL TEXT  

Bronchiolitis--Reply
King et al.
Arch Pediatr Adolesc Med 2004;158:708-708.
FULL TEXT  

Data on treating bronchiolitis is severely limited
BMJ 2004;328:.
FULL TEXT  

Limited Role of Tests for Pediatric Bronchiolitis and Drugs to Treat It
JWatch General 2004;2004:5-5.
FULL TEXT  

Managing Bronchiolitis and Respiratory Syncytial Virus: Finding the Yellow Brick Road
Hall
Arch Pediatr Adolesc Med 2004;158:111-112.
FULL TEXT  

Diagnosis and Testing in Bronchiolitis: A Systematic Review
Bordley et al.
Arch Pediatr Adolesc Med 2004;158:119-126.
ABSTRACT | FULL TEXT