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Q In children with bronchiolitis, what is the effectiveness of commonly used pharmacological treatments?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Paediatrics ★★★★★☆☆
Medline (January 1980 to November 2002), Cochrane Central Register of Controlled Trials, reference lists, and technical experts.
Study selection and assessment:
single or double blinded randomised controlled trials (RCTs) published in English that evaluated pharmacological treatments for bronchiolitis in ⩾10 children.
death, short and long term morbidity, and use of health services.
44 RCTs of commonly used interventions met the selection criteria. Study quality was rated as excellent in 7 RCTs, good in 20 RCTs, fair in 15 RCTs, and poor in 2 RCTs. Nebulised epinephrine (8 RCTs, 660 children). Epinephrine was better than salbutamol for reducing hospital admission or length of stay in 2 of 3 RCTs but did not differ from albuterol (1 of 1 RCT) or placebo (2 of 2 RCTs). 3 of 5 RCTs showed better clinical scores immediately after epinephrine treatment than after control treatment, but the difference did not persist at 24 and 36 hours (1 RCT). β2 agonist bronchodilators (13 RCTs, 956 children). None of …
For correspondence: Dr V J King, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Source of funding: Agency for Healthcare Research and Quality.