Format

Send to

Choose Destination
Allergol Immunopathol (Madr). 2014 Jul-Aug;42(4):307-15. doi: 10.1016/j.aller.2013.02.010. Epub 2013 Jun 14.

Overuse of bronchodilators and steroids in bronchiolitis of different severity: bronchiolitis-study of variability, appropriateness, and adequacy.

Collaborators (187)

Gámez Gómez MD, Batlles Garrido J, Cabrera Servilla JE, García Escobar I, Giménez Sánchez F, Ruiz Tudela L, Fernández Valverde A, Bueno Rodríguez MG, Ramón Faba I, Praena Crespo M, Castillo Laita JA, Macipe Costa R, Campos Calleja C, García Jiménez MC, Pérez Delgado R, Romero Salas Y, López Benito M, Martínez Suárez V, García Balbuena M, Mora Gandarillas I, Pérez Candás JI, Fernández Pérez M, Gonzavo Rodríguez C, Cobo Ruisánchez A, Yáñez Meana B, Hernandez Encinas A, Domínguez Aurrecoechea B, García Adaro M, Buznego Sánchez R, Fernández Francés M, Franco I, Ballesteros S, Benito Martín M, Mira López AJ, Fernández López M, Molinos Norniella C, Pérez Méndez C, Fernández Fernández E, Fernández Antuña J, Rodríguez Suárez J, Jiménez Treviño S, Álvarez Caro F, Todorcevic S, García Luzardo MR, BercedoSanz A, Cabero Pérez MJ, Álvarez Granda L, Pérez Belmonte E, Lapeña López de Armentia S, Morales Sánchez R, Fernández Pérez L, Alberola López S, Pérez García I, Camina Gutiérrez AB, Santos García J, Casares Alonso I, Cano Garcinuño A, Urueña Leal C, Andrés de Llano JM, Fernández Alonso JE, Bartolomé Porro JM, Sánchez Jiménez MC, Estévez Amores MJ, Mendoza Sánchez M, López Ávila J, Martín Ruano A, Martín Ruano J, de Dios Martín B, Fernández de Miguel S, Sánchez Granados JM, Serrano Ayestaran O, Conde Redondo F, del Río López A, Matías del Pozo V, Centeno Malfaz F, Alcalde Martín C, Bello Martínez B, Crespo Valderrábano L, Gutiérrez Abad C, Vázquez Fernández ME, Cortés Gabaudán A, Miguélez Vara MM, Pérez García P, García Vicente S, Prieto Figuero M, Piorno Hernández MJ, Jesús Moro Pérez M, Ochoa Sangrador C, Bajo Delgado AF, Fernández Testa A, Ortega Casanueva C, Ruiz Aragón G, Aizpurua Galdeano P, Claret Teruel G, Fernández Ureña S, Méndez Hernández M, Brossa Guerra F, Fàbrega Sabaté J, Cortés Marina RB, Fortea Gimeno E, Buñuel Alvarez JC, Vila Pablos C, Uriel Prat S, Mayol i Canals L, Buhedo Gordillo C, de Campos Rinero G, Mateo Moraleda MJ, Pérez Martín T, Redondo A, Sanguino A, Sepulcre B, Serra B, Tosao A, Galiano Olivares J, Rico Uriós CP, Sirvent Mayor MC, Fernández Tarí MJ, Fuggini MS, Comino Almenara L, Gutiérrez Roble E, Melnikova A, Riva M, Bernabé Gutiérrez A, Degtyareva I, Cañadas Olmo V, Goberna Burguera F, Mestre Ricote JL, González de Dios J, Rivas Juesas C, Fabregat Ferrer E, Palomares Gimeno MJ, Colomer Pellicer J, Úbeda Sansano I, Romero García M, Plaza Miranda A, Sánchez Medina C, Álvarez de Laviada Mulero T, Barona Zamora P, Asensi Monzó M, Gómez Málaga CM, Cuervo Valdés JJ, Barroso Espadero D, Amigo Ferreiro ME, García Fernández E, García Villar AI, Romaris Barca RM, Santos Tapia M, Miras Veiga A, Martinón Torres F, Martinón Torres N, Redondo Collazo L, Quintela Fernández MI, Fernández Cebrián SA, Pita Pérez MJ, Vadillo González F, Andrés Andrés AG, Lago Manchado P, Lorenzo Legerén C, Berrocal Castañeda M, Iglesias Meleiro JM, Colmenero E, Cortizas J, Martínez E, Conde A, Rodríguez P, Cortés Rico O, Aparicio Rodrigo M, Orejón de Luna G, Martín Mate MM, Duelo Marcos M, Indaberea Iguaran C, Nuñez Giralda A, Muñoz Velasco F, Perdikidis Oliveri L, Montón Álvarez JL, Orbe León V, Fernández Rodríguez M, Guerrero MM, Marañón Pardillo R, Peñalba Cítores A, Callén Blecua M, Korta Murua J, Mintegui Aramburu FJ, Olaciregui Echenique I, Rezola Arcelus E, González Díaz C, Sánchez Echaniz J.

Author information

1
Service of Pediatrics, Hospital Virgen de la Concha, Zamora, Spain. Electronic address: cochoas@meditex.es.
2
Service of Pediatrics, Hospital General Universitario de Alicante, Department of Pediatrics, Universidad Miguel Hernández, Alicante, Spain.

Abstract

BACKGROUND:

In the management of acute bronchiolitis there is a generalised use of treatments that have not been shown to be useful or efficacious in clinical studies. The objective of this study was to determine the appropriateness in the treatment of acute bronchiolitis of different severity within different clinical care settings.

METHODS:

This is a cross-sectional, descriptive study of 5647 cases of acute bronchiolitis in 91 Spanish hospitals and primary care centres. We classified the appropriateness of the treatments according to the recommendations of a consensus conference.

RESULTS:

There was an inappropriate use of treatments in 58.3% of the cases during the acute phase and in 45.4% during the maintenance phase. There was a generalised use of inhaled beta 2 agonists, regardless of the severity of the patients (hospitalised patients 69.3%, emergency care 63.2% and ambulatory 64.1%). Adrenaline was used in 30.1% of hospitalised cases and in 80.2% of intensive care patients. Systemic corticosteroids were not only used in one-third of hospitalised patients but also in 25.8% of ambulatory cases.

CONCLUSIONS:

In acute bronchiolitis in Spain there is a wide use of treatments that are not recommended by the available clinical practice guidelines. Beta 2 agonist bronchodilators and corticosteroids are widely used and maintained, regardless of the severity of the patients.

KEYWORDS:

Acute bronchiolitis; Bronchodilators; Corticosteroids; Physician's practice patterns; Treatment

PMID:
23769739
DOI:
10.1016/j.aller.2013.02.010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Ediciones Doyma, S.L.
Loading ...
Support Center