Chesty babies - bronchiolitis

A useful update into current management of bronchiolitis - the commonest lower respiratory tract infection to affect infants.

• No evidence of benefit from antibiotics or oral steroids
• Inhaled salbutamol, theophyllines, and adrenaline do not have strong evidence for their use
• Limited evidence for antiviral ribavirin - currently used for immunosuppressed children only
• Admit to hospital if child is hypoxic, dehydrated, or high risk, eg immunosupressed (oxygen and nasogastric feeding are still the mainstays of hospital treatment)
• After bronchiolitis, a child remains likely to get respiratory symptoms like wheeze, which can last until early adolescence
• Immunisation against RSV is an option - RSV is the commonest but not only cause of bronchiolitis

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Source: Archives of Disease in Childhood 2008;93:793-798