J L Kimpen1, U B Schaad. 1. Beatrix Children's Hospital, University Hospital Groningen, The Netherlands. j.l.l.kimpen@med.rug.nl
Abstract
BACKGROUND: Among the lower respiratory tract infections during infancy requiring hospitalization, respiratory syncytial virus (RSV) bronchiolitis is the most frequent disease entity. Nevertheless treatment remains controversial. METHODS: A poll among the European Society for Paediatric Infectious Diseases (ESPID) members was conducted to determine the respective local and national treatment policies of RSV bronchiolitis. RESULTS: The questionnaire was returned by 88 centers represented in ESPID (response rate 64%). Ribavirin was used occasionally for high risk patients in 34 centers although 16 hospitals follow the guidelines of the Red Book Committee of the American Academy of Pediatrics. There were no centers using ribavirin for all patients. Bronchodilator treatment was used universally in various combinations for all patients in 54 centers and for all high risk patients in 15. Corticosteroids were used by > 80% of ESPID colleagues in various combinations of administration routes. CONCLUSION: The lack of effective treatment for RSV bronchiolitis and the controversy in the literature concerning antiviral, bronchodilator and antiinflammatory therapy leads to inconsistent treatment strategies.
BACKGROUND: Among the lower respiratory tract infections during infancy requiring hospitalization, respiratory syncytial virus (RSV) bronchiolitis is the most frequent disease entity. Nevertheless treatment remains controversial. METHODS: A poll among the European Society for Paediatric Infectious Diseases (ESPID) members was conducted to determine the respective local and national treatment policies of RSV bronchiolitis. RESULTS: The questionnaire was returned by 88 centers represented in ESPID (response rate 64%). Ribavirin was used occasionally for high risk patients in 34 centers although 16 hospitals follow the guidelines of the Red Book Committee of the American Academy of Pediatrics. There were no centers using ribavirin for all patients. Bronchodilator treatment was used universally in various combinations for all patients in 54 centers and for all high risk patients in 15. Corticosteroids were used by > 80% of ESPID colleagues in various combinations of administration routes. CONCLUSION: The lack of effective treatment for RSV bronchiolitis and the controversy in the literature concerning antiviral, bronchodilator and antiinflammatory therapy leads to inconsistent treatment strategies.
Authors: John P DeVincenzo; Tom Wilkinson; Akshay Vaishnaw; Jeff Cehelsky; Rachel Meyers; Saraswathy Nochur; Lisa Harrison; Patricia Meeking; Alex Mann; Elizabeth Moane; John Oxford; Rajat Pareek; Ryves Moore; Ed Walsh; Robert Studholme; Preston Dorsett; Rene Alvarez; Robert Lambkin-Williams Journal: Am J Respir Crit Care Med Date: 2010-07-09 Impact factor: 21.405