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Evidence-based medicine
Review: commonly used pharmacological treatments for bronchiolitis in children do not seem to be effective

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    King VJ, Viswanathan M, Bordley WC, et al. Pharmacologic treatment of bronchiolitis in infants and children: a systematic review. Arch Pediatr Adolesc Med 2004;158:127–37.OpenUrlCrossRefPubMedWeb of Science

    Q In children with bronchiolitis, what is the effectiveness of commonly used pharmacological treatments?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Paediatrics ★★★★★☆☆

    METHODS

    Embedded ImageData sources:

    Medline (January 1980 to November 2002), Cochrane Central Register of Controlled Trials, reference lists, and technical experts.

    Embedded ImageStudy selection and assessment:

    single or double blinded randomised controlled trials (RCTs) published in English that evaluated pharmacological treatments for bronchiolitis in ⩾10 children.

    Embedded ImageOutcomes:

    death, short and long term morbidity, and use of health services.

    MAIN RESULTS

    44 RCTs of commonly used interventions met the selection criteria. Study quality was rated as excellent in 7 RCTs, good in 20 RCTs, fair in 15 RCTs, and poor in 2 RCTs. Nebulised epinephrine (8 RCTs, 660 children). Epinephrine was better than salbutamol for reducing hospital admission or length of stay in 2 of 3 RCTs but did not differ from albuterol (1 of 1 RCT) or placebo (2 of 2 RCTs). 3 of 5 RCTs showed better clinical scores immediately after epinephrine treatment than after control treatment, but the difference did …

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    Footnotes

    • For correspondence: Dr V J King University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    • Source of funding: Agency for Healthcare Research and Quality.

    Footnotes