Overuse of bronchodilators and steroids in bronchiolitis of different severity: bronchiolitis-study of variability, appropriateness, and adequacy.
| Autor: | Ochoa Sangrador C; Service of Pediatrics, Hospital Virgen de la Concha, Zamora, Spain. Electronic address: cochoas@meditex.es., González de Dios J; Service of Pediatrics, Hospital General Universitario de Alicante, Department of Pediatrics, Universidad Miguel Hernández, Alicante, Spain. |
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| Jazyk: | angličtina |
| Zdroj: | Allergologia et immunopathologia [Allergol Immunopathol (Madr)] 2014 Jul-Aug; Vol. 42 (4), pp. 307-15. Date of Electronic Publication: 2013 Jun 14. |
| DOI: | 10.1016/j.aller.2013.02.010 |
| Abstrakt: | Background: In the management of acute bronchiolitis there is a generalised use of treatments that have not been shown to be useful or efficacious in clinical studies. The objective of this study was to determine the appropriateness in the treatment of acute bronchiolitis of different severity within different clinical care settings. Methods: This is a cross-sectional, descriptive study of 5647 cases of acute bronchiolitis in 91 Spanish hospitals and primary care centres. We classified the appropriateness of the treatments according to the recommendations of a consensus conference. Results: There was an inappropriate use of treatments in 58.3% of the cases during the acute phase and in 45.4% during the maintenance phase. There was a generalised use of inhaled beta 2 agonists, regardless of the severity of the patients (hospitalised patients 69.3%, emergency care 63.2% and ambulatory 64.1%). Adrenaline was used in 30.1% of hospitalised cases and in 80.2% of intensive care patients. Systemic corticosteroids were not only used in one-third of hospitalised patients but also in 25.8% of ambulatory cases. Conclusions: In acute bronchiolitis in Spain there is a wide use of treatments that are not recommended by the available clinical practice guidelines. Beta 2 agonist bronchodilators and corticosteroids are widely used and maintained, regardless of the severity of the patients. (Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.) |
| Databáze: | MEDLINE |
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