Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy

Bronchiolitis is the most common lower respiratory tract infection in infants. According to evidence-based guidelines, diagnosis is clinical, there is no need for routine use of laboratory or instrumental tests and therapy is primarily supportive, based on oxygen and adequate fluid supplementation....

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Carlotta Biagi, Sara Scarpini, Camilla Paleari, Marianna Fabi, Arianna Dondi, Liliana Gabrielli, Monia Gennari, Marcello Lanari, Luca Pierantoni
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bronchiolitis evidence-based guidelines practice management treatment corticosteroids beta 2 agonists Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/7a807295c7f240b284d86b6a99b49a5c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7a807295c7f240b284d86b6a99b49a5c
record_format	dspace
spelling	oai:doaj.org-article:7a807295c7f240b284d86b6a99b49a5c2021-11-25T18:24:21ZImpact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy10.3390/microorganisms91122212076-2607https://doaj.org/article/7a807295c7f240b284d86b6a99b49a5c2021-10-01T00:00:00Zhttps://www.mdpi.com/2076-2607/9/11/2221https://doaj.org/toc/2076-2607Bronchiolitis is the most common lower respiratory tract infection in infants. According to evidence-based guidelines, diagnosis is clinical, there is no need for routine use of laboratory or instrumental tests and therapy is primarily supportive, based on oxygen and adequate fluid supplementation. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. The aim of this retrospective cohort study was to evaluate how the management of bronchiolitis has changed in the last ten years in a Tertiary Care Center in Italy, assessing adherence to national guidelines. Considering the publication of the Italian inter-society consensus document in 2014, we compared patients admitted in the prior four epidemic seasons with patients admitted in the latter six epidemic seasons. The comparison between the two groups showed a significant reduction in the prescription of systemic corticosteroids (58.9% vs. 41.8%, <i>p</i> < 0.001), nebulized epinephrine (73.8% vs. 38.3%, <i>p</i> < 0.001) and antibiotics (59.5% vs. 42.3%, <i>p</i> < 0.001), together with a drastic decrease in the use of chest X-ray (92.2% vs. 54.4%, <i>p</i> < 0.001). On the contrary, the use of inhaled salbutamol remained substantially stable over time (39.4% vs. 37.6%, <i>p</i> = 0.505). Despite the encouraging results, further efforts are needed to limit the prescription of ineffective therapies like antibiotics and inhaled salbutamol.Carlotta BiagiSara ScarpiniCamilla PaleariMarianna FabiArianna DondiLiliana GabrielliMonia GennariMarcello LanariLuca PierantoniMDPI AGarticlebronchiolitisevidence-based guidelinespractice managementtreatmentcorticosteroidsbeta 2 agonistsBiology (General)QH301-705.5ENMicroorganisms, Vol 9, Iss 2221, p 2221 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bronchiolitis evidence-based guidelines practice management treatment corticosteroids beta 2 agonists Biology (General) QH301-705.5
spellingShingle	bronchiolitis evidence-based guidelines practice management treatment corticosteroids beta 2 agonists Biology (General) QH301-705.5 Carlotta Biagi Sara Scarpini Camilla Paleari Marianna Fabi Arianna Dondi Liliana Gabrielli Monia Gennari Marcello Lanari Luca Pierantoni Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy
description	Bronchiolitis is the most common lower respiratory tract infection in infants. According to evidence-based guidelines, diagnosis is clinical, there is no need for routine use of laboratory or instrumental tests and therapy is primarily supportive, based on oxygen and adequate fluid supplementation. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. The aim of this retrospective cohort study was to evaluate how the management of bronchiolitis has changed in the last ten years in a Tertiary Care Center in Italy, assessing adherence to national guidelines. Considering the publication of the Italian inter-society consensus document in 2014, we compared patients admitted in the prior four epidemic seasons with patients admitted in the latter six epidemic seasons. The comparison between the two groups showed a significant reduction in the prescription of systemic corticosteroids (58.9% vs. 41.8%, <i>p</i> < 0.001), nebulized epinephrine (73.8% vs. 38.3%, <i>p</i> < 0.001) and antibiotics (59.5% vs. 42.3%, <i>p</i> < 0.001), together with a drastic decrease in the use of chest X-ray (92.2% vs. 54.4%, <i>p</i> < 0.001). On the contrary, the use of inhaled salbutamol remained substantially stable over time (39.4% vs. 37.6%, <i>p</i> = 0.505). Despite the encouraging results, further efforts are needed to limit the prescription of ineffective therapies like antibiotics and inhaled salbutamol.
format	article
author	Carlotta Biagi Sara Scarpini Camilla Paleari Marianna Fabi Arianna Dondi Liliana Gabrielli Monia Gennari Marcello Lanari Luca Pierantoni
author_facet	Carlotta Biagi Sara Scarpini Camilla Paleari Marianna Fabi Arianna Dondi Liliana Gabrielli Monia Gennari Marcello Lanari Luca Pierantoni
author_sort	Carlotta Biagi
title	Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy
title_short	Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy
title_full	Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy
title_fullStr	Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy
title_full_unstemmed	Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy
title_sort	impact of guidelines publication on acute bronchiolitis management: 10-year experience from a tertiary care center in italy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7a807295c7f240b284d86b6a99b49a5c
work_keys_str_mv	AT carlottabiagi impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT sarascarpini impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT camillapaleari impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT mariannafabi impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT ariannadondi impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT lilianagabrielli impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT moniagennari impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT marcellolanari impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly AT lucapierantoni impactofguidelinespublicationonacutebronchiolitismanagement10yearexperiencefromatertiarycarecenterinitaly
_version_	1718411206815907840

Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy

Ejemplares similares