Acute bronchiolitis in Switzerland - Current management and comparison over the last two decades.

Hartog, K; Ardura Garcia, C; Hammer, J; Kuehni, CE; Barben, J (2022). Acute bronchiolitis in Switzerland - Current management and comparison over the last two decades. Pediatric pulmonology, 57(3), pp. 734-743. Wiley-Blackwell 10.1002/ppul.25786

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BACKGROUND

Although international guidelines and Cochrane reviews emphasize that therapies do not alter the natural course of acute viral bronchiolitis (AVB), they are still prescribed frequently. This survey evaluated self-reported management of AVB by Swiss pediatricians in 2019 and compared it with previous surveys.

METHODS

We performed a cross-sectional online survey of all board-certified pediatricians in Switzerland in November 2019 and compared reported use of therapies with that reported in the 2001 and 2006 surveys. We used multivariable ordered logistic regression to assess factors associated with reported prescription of bronchodilators, corticosteroids, antibiotics and physiotherapy.

RESULTS

Among 1618 contacted board-certified pediatricians, 884 returned the questionnaires (55% response rate). After exclusions were applied, 679 were included in the final analysis. Paediatricians working in primary care reported using therapeutics more frequently than those working in a hospital setting, either always or sometimes: bronchodilators 53% vs 38%, corticosteroids 37% vs 23% and antibiotics 39% vs 22%. The opposite occurred with physiotherapy: 53% reported prescribing it in hospital and 44% in primary care. There was an overall decrease in the prescription of therapeutics and interventions for AVB from 2001 to 2019. The proportion who reported "always" prescribing corticosteroids decreased from 71% to 2% in primary care, and of those "always" prescribing bronchodilators from 55% to 1% in hospitals.

CONCLUSION

Although we observed a significant decrease since 2001, more effort is required to reduce the use of unnecessary therapies in children with AVB. This article is protected by copyright. All rights reserved.

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