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Arch Pediatr Adolesc Med. 2004;158:708.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In reply

We appreciate Dr DiTraglia's observation that there appeared to be a conflict between the conclusions of our systematic reviews on the diagnosis and treatment of bronchiolitis^1-2 and the study by Mull et al³ comparing nebulized epinephrine and albuterol for the treatment of bronchiolitis in infants. We would agree with Dr DiTraglia that there is, in his words, a "... disconnect between the evidence and the practice of pediatrics in America." Our review included 9 randomized controlled trials of epinephrine vs a placebo and/or a 2-agonist. The weight of evidence from these studies does not support the routine use of either nebulized epinephrine nor 2-agonists for bronchiolitis. The study by Mull and colleagues was obviously not published prior to the completion of our review, but its inclusion would not have altered our conclusions. The ARCHIVES recently published a meta-analysis by Hartling et al⁴ of randomized controlled trials evaluating the . . . [Full Text of this Article]

Valerie J. King, MD, MPH; W. Clayton Bordley, MD, MPH; Meera Viswanathan, PhD

Correspondence: Dr King, Family Medicine, Oregon Health and Science University, Portland, OR 972239 (kingv@ohsu.edu)

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