Management of Bronchiolitis with or without Antibiotics  A Randomized Control Trial

Mazumder, Jashim Uddin; Hossain, Mohammad Monir; Kabir, Ahmedul

doi:10.3329/jbcps.v27i2.4248

Cited by 12 publications

(11 citation statements)

References 7 publications

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“…This finding matches with other`s findings. 19,20,21 On the day of admission 100% children had rhonchi, after 4 day, about one-third of the total children had rhonchi; 36% of antibiotic group and 31% of without antibiotic group (p>0.5). After 4 days of admission 17% of antibiotic group and 14% of without antibiotic group had crepitation and 6 days after discharge 1(1%) child of without antibiotic group and 2(2%) from antibiotic group still had crepitation, but the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 96%

“…Few randomized control studies conducted so far on use of antibiotic in bronchiolitis, also found no evidence to support the use of antibiotics for bronchiolitis. 19,20,24,25 The cardinal radiological features of bronchiolitis are hyperinflation of the lung fields, increase interstitial markings and streaky opacities. Our experience is same, hypertranslucency in 74% and hyperinflation in 64% in cases.…”

Section: Discussionmentioning

confidence: 99%

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Role of Antibiotic in Treatment of Bronchiolitis

Das¹,

Hossain²,

Basak³

et al. 2018

TAJ: J of Teachers Assoc

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Background: Acute bronchiolitis is a viral respiratory illness of infants and young children. It is characterized by coryzal symptoms followed by rapid onset of cough, wheeze, fever, tachypnea, chest recession and crepitation with radiological evidence of hyperinflation. Bronchiolitis occurs in first 2 years of age and is usually caused by respiratory syncytial virus. Objective: To find out the effectiveness of antibiotic in treatment of bronchiolitis.Methods: It was a randomized controlled trial carried out in Department of Paediatrics, Rajshahi Medical College Hospital, Rajshahi. 200 acute bronchiohtis patient admitted into paediatric ward of Rajshahi Medical College Hospital who fulfill inclusion criteria. Then relevant history and physical examination findings were recorded in data sheet. The even numbered patient was selected as control group and odd numbered patients as intervention group. The control group was receive supportive management and intervention group was receive lnj. Ceftriaxone 75mg/kg/day in for 5 days along with supportive management.Results: This study it was observed that bronchiolitis was more common in male. The age for peak incidence (75%) of bronchiolitis was 2-6 months. About 59% children presented with fever and all of them recovered from fever quickly before leaving hospital. At the time of admission 43% children had feeding difficulty, which improved steadily and similarly in both the groups. For days hours after admission 16% of antibiotic group and 15% of without antibiotic group had similar chest indrawing. Cough was the most common starting symptoms. None of the cases showed cyanosis and at the time of admission total 91% children had SpO2 <95%, after 4 days of admission 33%of antibiotic group and 14% of without antibiotic group still had SpO2 <95% but during discharge none of them had hypoxia. After 4 days of admission 17% of antibiotic group and 14% of without antibiotic group had crepitation and 6 days after discharge 1(1%) child of without antibiotic group and 2(2%) from antibiotic group still had crepitation. It was observed that hypertranslucency in 74% and hyperinflation in 64% in cases.Conclusion: This study shows antibiotics have no role in acute bronchiolitis management. Further multicenter study with larger sample size is recommended.TAJ 2013; 26: 43-47

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Role of Antibiotic in Treatment of Bronchiolitis

Das¹,

Hossain²,

Basak³

et al. 2018

TAJ: J of Teachers Assoc

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“…In their randomized controlled study of 126 patients aged 1-2 months and hospitalized with viral bronchiolitis, Mazumder et al 14 divided their subjects into three groups -receiving IV ampicillin, oral erythromycin, or no antibiotics. No significant difference was observed between these three groups in terms of clinical findings (decreased respiratory difficulty, feeding difficulty, and respiration rate, and return of social smiling).…”

Section: Discussionmentioning

confidence: 99%

“…11 Reported outcomes of the use of antibiotics in acute viral bronchiolitis in previous studies include no significant difference in severity of symptoms (decreased respiratory difficulty, feeding difficulty, and respiration rate, or restoration of social smiling), no statistically significant difference in terms of mean length of hospital stay, and no acceleration of healing, while unnecessary antibiotic use was also described as a financial burden leading to iatrogenic side-effects and resistant microorganisms. [12][13][14][15] However, one study reported significant decreases in oxygen and intravenous fluid support requirements in patients receiving clarithromycin compared to placebo. The duration of beta-2 agonist use was also shorter in the clarithromycin group, and repeat hospitalization rates were lower.…”

Section: Introductionmentioning

confidence: 99%

Does Clarithromycin Use in Acute Viral Bronchiolitis Shorten Length of Hospital Stay?

Esenülkü¹,

Hancı²

2020

J. Pediatr. Acad.

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Introduction: Acute bronchiolitis is the most common cause of hospitalization among infants. Although antibiotics are not recommended in the absence of secondary bacterial infection, rates of antibiotic usage is high rate in clinical practices Objectives: To test the hypothesis that clarithromycin use in infants with acute viral bronchiolitis shortens length of hospital stay. Materials and Methods: One hundred sixty-seven patients aged 1-24 months hospitalized for treatment with a diagnosis of acute viral bronchiolitis at pediatric clinic between April 2017 and May 2018 were investigated retrospectively. The patients were divided into two separate groups, Group A (122 patients), using clarithromycin therapy during hospitalization, and Group B (45 patients), which did not receive clarithromycin (Group B). Demographic and clinical data, treatments received, and duration of hospital stay were obtained from patients’ records. Results: The rate of clarithromycin use in this study was 73%. No statistically significant difference in length of hospital stay was determined between patients receiving clarithromycin and those receiving no antibiotic therapy. However, length of hospital stay decreased with age. Clarithromycin use elicited no statistically significant decrease in hospital stay in patients with acute viral bronchiolitis. Conclusions: The routine use of clarithromycin is not recommended in acute viral bronchiolitis in the light of its cost and side-effects, and the fact is has no impact on clinical status and hospital stay

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“…Majumder et al. (24) recently conducted another study involving 104 children. While the study was conducted in one hospital, it was done across three groups: one received ampicillin, the other erythromycin and one group received no antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh

et al. 2009

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Management of Bronchiolitis with or without Antibiotics A Randomized Control Trial

Cited by 12 publications

References 7 publications

Role of Antibiotic in Treatment of Bronchiolitis

Role of Antibiotic in Treatment of Bronchiolitis

Does Clarithromycin Use in Acute Viral Bronchiolitis Shorten Length of Hospital Stay?

Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh

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Management of Bronchiolitis with or without Antibiotics  A Randomized Control Trial

Cited by 12 publications

References 7 publications

Role of Antibiotic in Treatment of Bronchiolitis

Role of Antibiotic in Treatment of Bronchiolitis

Does Clarithromycin Use in Acute Viral Bronchiolitis Shorten Length of Hospital Stay?

Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh

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Management of Bronchiolitis with or without Antibiotics A Randomized Control Trial