{mosimage}Bronchiolitis and antibiotics
By Ramaz Mitaishvili
April 17 , 2007
Introduction
Bronchiolitis [brong”ke-o-li’tis] (inflammation of the bronchioles) is an acute viral illness. Treatment usually is supportive and antibiotics are not indicated. But most of physicians prescribe antibiotics for hospitalized patients. Such practice is explained, that elevated WBC can be caused by co-existent bacterial superinfection. This practice can be considered as irrational.
Subjects and Methods
This study was carried out at pediatric department. Three hundred pediatric cases admitted directly to the ICU department were studied prospectively. Cases aged between 7 month and 11 years admitted during the 14 month were enrolled into the study. Standard laboratory techniques were utilized to measure blood levels of WBC and etc. The clinical assessment of heart rate, respiratory rate, chest auscultation, chest percussion and etc. was made by a pediatricians at the time of admission. The children were followed up during hospital stay and the outcome recorded as a treated (by antibiotics) or not, hospital stay.
Conclusion
1. Antibiotics are overutilized in children, especially in infants with bronchiolitis.
2. A variety of viral causative agents have been identified and antibiotics are totally ineffective in prevention of bacterial complications.
3. Furthermore if bacterial superinfection develops, it becomes more resistant to treatment.
4. We did not see any significant differences between ages, race and sex in outcome.
5. 75% children were RSV positive.
6. Average hospital stay with antibioticotherapy 9,2 days
7. Average hospital stay not treated with antibiotics – 8, 5 days
8. 73% of children with bronchiolitis have increased WBC.
9. 17% of children with bronchiolitis have infiltrates on CXR
