1Pediatra di libera scelta, Piacenza; 2Pediatra di libera scelta, Modena; 3Pediatra di libera scelta, Bologna
4Pediatra di libera scelta, Reggio Emilia; 5Governo Clinico, AUSL di Modena
6Scuola di Specializzazione in Igiene e Medicina Preventiva, Università di Modena
Indirizzo per corrispondenza: firstname.lastname@example.org
Key words: Bronchiolitis, Therapy, Paediatricians, Medical education
Introduction - A cross-sectional study was conducted to evaluate the current clinical practice
in outpatient management of patients with bronchiolitis among paediatricians. The
evaluation was conducted taking into account clinical, therapeutic and qualitative outcomes
and adherence to international guidelines.
Materials and methods - The study was conducted between January 1, 2012 - May 31, 2013 in 4 Local Health Units in Emilia Romagna. All new cases of bronchiolitis in children aged < 12 months were registred by the paediatricians who participated in the study. Socio-demographic data, clinical parameters, therapy and hospital admission information were collected.
Results - Twenty-five paediatricians participated in the study and 109 cases of acute bronchiolitis were included. The mean age of patients was 4.6 months (range 1-9). The median clinical score of severity was 4.6 (range 1-9) and the highest scores were observed in 12 patients aged < 6 months. In 71.6% of cases no lab or instrumental exams were performed; the most used test was oxygen saturation measurement, SpO2 (28.4%). Beta-2 adrenergic agonists were the most common prescribed therapy (94.3%), followed by inhaled corticosteroids (54%), oral systemic corticosteroids (52%), antibiotics (34%) and adrenaline (9.2%). Seventy percent of patients were followed up within 48 hours. Hospital admission occurred in 27.6% of cases; clinical score of severity turned out to be the most useful criteria for hospitalization.
Conclusions - The results of the study show appropriate outpatient management of bronchiolitis by paediatricians: adequate use of diagnostic exams, appropriate follow-up schedules and hospitalizations. The analysis of therapeutic approaches highlights a higher use of beta2-adrenergic agonists and corticosteroids than indicated in international guidelines.
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