Infectious Disease Weekly Roundup – Week 2

ERs Not Following Guidance for Infants With Bronchiolitis

Antibiotics continue to be a routinely prescribed treatment throughout emergency rooms in the United States among infants diagnosed with bronchiolitis, according to new findings. According to data published in the Journal of the Pediatric Infectious Diseases Society, the research highlights a “concerning lag in translating evidence-based guidelines into clinical practice and underscore the need to continue educating healthcare providers and the public about appropriate antibiotic use.” The findings also come despite recommendations against the practice that were first issued more than 10 years ago by the American Academy of Pediatrics and that recommend against antibiotic treatment without a documented bacterial infection, according to a report by Science Daily.

The illness is said to be the leading cause of hospitalizations for U.S. children in their first year of life, but antibiotics offer no benefit because bronchiolitis develops when the lung’s bronchioles become inflamed and congested, typically due to a viral infection.

For the study, researchers analyzed data from a nationally representative survey of U.S. emergency room visits conducted annually by the Centers for Disease Control and Prevention, the report states. Between 2007 and 2015, approximately 25 percent of children under the age of 2 with bronchiolitis who were seen in an emergency room received antibiotics, which suggests minimal improvement in antibiotic prescribing compared to previous years, according to the report. There were no significant changes over time in antibiotic prescription rates during the nine years after the guidelines were published, the study found, citing that among 70 percent of patients who received antibiotics had no documented bacterial infection.

“Targeted interventions to reduce inappropriate prescribing among clinicians are essential,” said Brett Burstein, MD, PhD, MPH, of the Montreal Children’s Hospital and the Research Institute of the McGill University Health Centre in Montreal, Quebec, Canada, and senior author of the study. “But at the same time, informing the lay public about the potential downstream consequences and why it is important not to over-treat viral conditions are equally important.”

According to the Science Daily report, the new analysis also found that increased antibiotic prescribing was associated with receiving treatment in hospitals that were not teaching hospitals or pediatric hospitals, suggesting that these types of facilities may benefit the most from efforts to more effectively translate guidelines for appropriate bronchiolitis treatment into clinical practice changes.

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