Antibiotic treatment of pneumonia and bronchiolitis. A prospective randomised study.

Friis, B; Andersen, Per; Brenøe, Elisabeth; Hornsleth, A; Jensen, A. S.; Knudsen, Finn Ursin; Krasilnikoff, P. A.; Mordhorst, Carl H.; Nielsen, Søren R.K.; Uldall, P. R.

doi:10.1136/adc.59.11.1038

Cited by 106 publications

(55 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…105 Early RCTs 106,107 showed no benefit from antibacterial treatment of bronchiolitis. However, concern remains regarding the possibility of bacterial infections in young infants with bronchiolitis; thus, antibacterial agents continue to be used.…”

Section: Evidence Profile 4: Ribavirinmentioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

880

293

View full text Add to dashboard Cite

Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm.The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations.This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics.This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children with bronchiolitis. INTRODUCTIONTHIS GUIDELINE EXAMINES the published evidence on diagnosis and acute management of the child with bronchiolitis in both outpatient and hospital settings, including the roles of supportive therapy, oxygen, bronchodilators, antiinflammatory agents, antibacterial agents, and antiviral agents and make recommendations to influence clinician behavior on the basis of the evidence. Methods of prevention All clinical practice guidelines from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care. Variations, taking into account individual circumstances, may be appropriate. Key Word bronchiolitisAbbreviations CAM-complementary and alternative medicine LRTI-lower respiratory tract infection AHRQ-Agency for Healthcare Research and Quality RSV-respiratory syncytial virus AAP-American Academy of Pediatrics AAFP-American Academy...

show abstract

Section: Evidence Profile 4: Ribavirinmentioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

880

293

View full text Add to dashboard Cite

show abstract

“…Based on signs of clinical deterioration during admission Hall et al [2] found only 1.2 %, while studies using antibody increase in serum or antigen detection in serum or urine find an incidence of up to 44 % [3,4]. Two randomized controlled studies have evaluated the efficacy of antibiotics in patients with RSV-LRTI and found that antibiotics are not beneficial [5,6]. However, these studies not only excluded patients requiring mechanical ventilation but also had a number of methodological problems.…”

mentioning

confidence: 99%

Antibiotic use in pediatric intensive care patients with lower respiratory tract infection due to respiratory syncytial virus

et al. 2001

View full text Add to dashboard Cite

“…Studies have failed to demonstrate any benefit in hospitalized infants with bronchiolitis. The only role for antibiotics is in complicated bronchiolitis where a secondary bacterial infection, such as with streptococcus or staphylococcus, is suspected (Friis et al 1984). However, studies have demonstrated that infants with RSV infection are at a lower risk from serious bacterial infection than patients without RSV infection (Levine et al 2004).…”

Section: Respiratory Syncytial Virus Infectionsmentioning

confidence: 99%

Respiratory syncytial virus infections: characteristics and treatment

Chidgey

Broadley

2005

Journal of Pharmacy and Pharmacology

View full text Add to dashboard Cite

In this review, we describe the history, epidemiology and clinical manifestations of infections attributed to respiratory syncytial virus (RSV) in children. At present, no cure exists for RSV infection but commonly employed palliative treatments include oxygen and inhaled 2 -adrenoceptor agonists, such as salbutamol, to relieve the wheezing and increased bronchiolar smooth muscle constriction. Adrenaline (epinephrine) has been found to be superior to the selective 2 -adrenoceptor agonists. Oral or inhaled corticosteroids should counteract the inflammatory response to RSV infection but their effectiveness is controversial. Inhaled ribavirin is the only licensed antiviral product approved for the treatment of RSV lower respiratory-tract infection in hospitalized children, although its use is now restricted to high-risk infants. Other treatments considered are nasopharyngeal suctioning, surfactant therapy, recombinant human deoxyribonuclease I, heliox (helium:oxygen) and inhaled nitric oxide. Prevention of infection by RSV antibodies is another strategy and, currently, palivizumab is the only safe, effective and convenient preventative treatment for RSV disease in highrisk populations of infants and young children. Its cost-effectiveness, however, has been questioned. Both live attenuated and subunit vaccines against RSV infection have been developed but so far there is no safe and effective vaccine available. Finding effective treatments and prophylactic measures remains a major challenge for the future.

show abstract

Antibiotic treatment of pneumonia and bronchiolitis. A prospective randomised study.

Cited by 106 publications

References 18 publications

Diagnosis and Management of Bronchiolitis

Diagnosis and Management of Bronchiolitis

Antibiotic use in pediatric intensive care patients with lower respiratory tract infection due to respiratory syncytial virus

Respiratory syncytial virus infections: characteristics and treatment

Contact Info

Product

Resources

About