Antibiotics for Persistent Cough or Wheeze Following Acute Bronchiolitis in Children (Review)

E. J. Plumb, A. B. Chang, P. S. Morris, G. B. McCallum

    Research output: Contribution to journalMeeting Abstract

    Abstract

    Introduction/Aim: Bronchiolitis is a significant health burden globally. It is a clinically diagnosed condition, characterised by tachypnoea; crackles and/or wheeze in children <2 years. Although typically self‐limiting, persistent symptoms may continue beyond the acute phase (<14 days), increasing the burden of disease and risk of re‐hospitalisation. This review aims to determine the efficacy of antibiotics, compared to a control, to reduce persistent respiratory symptoms following acute bronchiolitis (within six months of illness).

    Methods: The previous review was updated in August 2016, using the following databases: Cochrane Airways Group Register of Trials; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; Clinicaltrials.gov; WHO Trial Portal; and the Australian and New Zealand Clinical Trials Registry.

    Two review authors independently assessed articles against predetermined selection criteria: randomised controlled trials (RCTs), comparing antibiotics with controls, in the post‐acute phase of bronchiolitis (>14 days), in children < 2 years of age diagnosed with bronchiolitis.

    Results: Of 344 papers retrieved, only 2 studies1,2 involving 249 children were included. Using an intention‐to‐treat analysis at 6 months, no significant difference was observed between treatment groups for the primary outcomes: number not cured at follow up (OR 0.69; 95%CI 0.37 – 1.28.), or the number re‐hospitalised with respiratory illness (OR 1.19; 95%CI 0.67 ‐ 2.12). There was no significant difference for any of the secondary outcomes at 6 months: recurrent wheeze (OR 0.78; 95%CI 0.35 – 1.73) or bacterial resistance (OR 0.78; 95%CI 0.31 – 1.94).

    Conclusion: There is currently no evidence to support the use of antibiotic treatment at the point of illness to prevent post‐acute bronchiolitis symptoms. However, there were only 2 studies and children were randomised at the point of bronchiolitis. No studies have randomised children at the point of symptom persistence confirming the need for further RCTs to inform clinical practice.
    Original languageEnglish
    Article numberTO-017
    Pages (from-to)26-26
    Number of pages1
    JournalRespirology
    Volume22
    Issue numberS2
    DOIs
    Publication statusPublished - 15 Mar 2017

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