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

Kabir, Arml; Mollah, Abid Hossain; Anwar, K. S.; Rahman, Azizur; Amin, Ruhul; Rahman, Muhammad Khalilur

doi:10.1111/j.1651-2227.2009.01389.x

Cited by 32 publications

(41 citation statements)

References 19 publications

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“…10 Kabir et al showed that most of the children were within 2-12 months of age (71.5%). 5 Bradley et al found age as a significant factor in severity of infection; the younger the infant, the more severe the infection. 11 Sex distribution of the patients (male:female; 1.9:1) was almost similar to the study of Bashar et al who found male to female ratio 1.8:1 whereas Kabir et al showed male:female ratio 2.7:1.…”

Section: Discussionmentioning

confidence: 99%

“…3 Risk factors implicated in the development of severe bronchiolitis include young age, male sex, parental smoking, low socioeconomic background, using of wood burning stoves, and non-breastfeeding child. 1,4,5 Environmental tobacco smoke (ETS) is an important and established risk factor for both susceptibility and severity of bronchiolitis. 6 Currently, there are 1.3 billion smokers in the world.…”

Section: Introductionmentioning

confidence: 99%

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Role of parental smoking in severe bronchiolitis: a hospital based case-control study

Ismael¹,

Jose²

2017

Int J Contemp Pediatr

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Background: Bronchiolitis is one of the commonest causes of hospitalization of infants and young children in India. Parental smoking is an important risk factor for both susceptibility and severity of bronchiolitis. Paternal smoking alone causes a 1.3-fold (95% CI = 1.2-1.4) increase in risk. The aim of this study was to find out the role of parental smoking in severe bronchiolitis.Methods: This is a case control study conducted in the Department of Pediatrics from July 2013 to December 2015. Sixty-four patients admitted into the ward with severe bronchiolitis were enrolled as cases and sixty-four suitably matched apparently healthy children attending EPI centre and outpatient department presenting with non-respiratory illness were enrolled as controls. Every second case satisfying the inclusion and exclusion criteria was enrolled in the study.Results: The mean age of the patients was 8.53 (SD±4.75) months. Forty-two (65%) patients were male and twenty-two (34.3%) patients were female. Male-to-female ratio was 1.9:1. Most of the cases (62.5%) came from low socioeconomic background. More than half of the cases (53.13%) were not exclusively breastfed babies. Mean length of hospital stay was SD (5.41±2.82) days. Thirty-nine (60%) cases and twenty-three (35%) controls were exposed to parental smoking. Result was highly significant (p = 0.005). Odds ratio was 2.8 (95% CI from 1.36 to 5.68).Conclusion: Exposure to parental smoking causes a statistically significant (p = 0.005, odds ratio = 2.8) increase in the risk of developing severe bronchiolitis in the first year of life

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of parental smoking in severe bronchiolitis: a hospital based case-control study

Ismael¹,

Jose²

2017

Int J Contemp Pediatr

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“…It is known that poor nutrition is one of the causes of microcephaly 16 . In this study under nutrition and wasting is more prevalent in pneumonia group and consistently microcephaly is also significantly more in pneumonia group in comparison to bronchiolitis group (p<0.05).…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Nutritional Status of Children (02-24 Months) with Acute Bronchiolitis and Pneumonia

Shampa¹,

Mollah

Billah

et al. 2017

J. Bangladesh Coll. Phys.

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Summary:Background: Acute Bronchiolitis and pneumonia pose significant morbidity and mortality of under five children. This outcome is further influenced by poor nutritional status of the affected child because of depressed immunity.Objective: We sought to evaluate nutritional status of children suffering from acute bronchiolitis and pneumonia in Bangladesh.Methods: This cross sectional study was conducted in the Department of Pediatrics of Dhaka Medical College Hospital and Dhaka Shishu Hospital from July, 2010 to June, 2011. A total of 50 patients of pneumonia aged 2-24 months and 50 patients of acute bronchiolitis of same age were enrolled in this study according to case definitions. After enrolment, the patients were thoroughly assessed with particular emphasis on the anthropometric measurements. Weight, length, MUAC and OFC were measured and recorded in a pretested semi structured questionnaire. For each group Z score of weight for age, weight for length, length for age, OFC and MUAC were calculated. Z score +2 to -1 was defined as normal, -1 to -2 z score as mild poor, -2 to -3 z score as moderate poor and <-3 z score was defined as severe poor status. Results were compared between pneumonia group and bronchiolitis group by using calculated Z value. A calculated Z value more than 1.96 was regarded significant (calculated z value > 1.96 is equivalent to p value< 0.05).Results: Children with pneumonia more often had severe underweight (weight for age <-3 SD) (50% vs. 30%, p= 0.04), microcephaly (OFC <-3SD) (30% vs. 12%, p= 0.03), and low MUAC (<115 mm) (40% vs. 10%, p= 0.03) compared to those with bronchiolitis. Although, there was an increased trend of severe wasting (weight for length <-3 SD) and severe stunting (length for age <-3 SD) in children with pneumonia compared to those with bronchiolitis, the difference was not significant.Conclusion: There thus, the overall nutritional status in children having pneumonia was poor compared to those with bronchiolitis. However, multicenter case control study with larger sample is imperative to consolidate our observation.

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“…Macrolides are thought to have anti-inflammatory activities as well as antibiotic activity (Culic et al, 2001), and so are thought to have potential benefit for treating bronchiolitis. Of the five studies included in the review, one smaller study including 21 children found that clarithromycin treatment may reduce hospital admission (8% clarithromycin versus 44% placebo, P = 0.081), but this study was associated with a potential higher risk of performance, detection and reporting bias (Kabir et al, 2009). One other study found mixed results for the effects of antibiotics on wheeze, but did not identify any difference for other symptom measures (Mazumder et al, 2009).…”

Section: Antibioticsmentioning

confidence: 99%

“…One other study found mixed results for the effects of antibiotics on wheeze, but did not identify any difference for other symptom measures (Mazumder et al, 2009). Four included studies did not find any difference between antibiotics and placebo for their primary outcomes of length of illness (Field et al, 1966) or lengt of hospital stay (Kabir et al, 2009;Kneyber et al, 2008;Mazumder et al, 2009). Despite these results, antibiotics are commonly used in 34% to 99% of hospitalized infants, even in those that do not require mechanical ventilation (Kabir et al, 2003;Vogel et al, 2003).…”

Section: Antibioticsmentioning

confidence: 99%

Treatment of Respiratory Syncytial Virus Infection: Past, Present and Future

Roymans¹,

Koul²

2011

Human Respiratory Syncytial Virus Infection

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

Abstract: In hospital settings, managing bronchiolitis with only supportive measures but without antibiotics remains preferable.

Cited by 32 publications

References 19 publications

Role of parental smoking in severe bronchiolitis: a hospital based case-control study

Role of parental smoking in severe bronchiolitis: a hospital based case-control study

Comparative Study of Nutritional Status of Children (02-24 Months) with Acute Bronchiolitis and Pneumonia

Treatment of Respiratory Syncytial Virus Infection: Past, Present and Future

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