Antibiotics for bronchiolitis in children

摘要: Background Bronchiolitis is a serious, potentially life-threatening respiratory illness commonly affecting babies. It often caused by syncytial virus (RSV). Antibiotics are not recommended for bronchiolitis unless there concern about complications such as secondary bacterial pneumonia or failure. Nevertheless, they used at rates of 34% to 99% in uncomplicated cases. Objectives To evaluate the effectiveness antibiotics bronchiolitis. Search methods We searched Cochrane Central Register Controlled Trials (CENTRAL 2010, issue 4), which includes Acute Respiratory Infection Group's Specialised Register, and Database Abstracts Reviews Effects, MEDLINE (January 1966 November 2010), EMBASE (1990 December 2010) Current Contents (2001 2010). Selection criteria Randomised controlled trials (RCTs) comparing placebo children under two years diagnosed with bronchiolitis, using clinical criteria (including distress preceded coryzal symptoms without fever). Primary outcomes included time resolution signs (pulmonary markers distress, wheeze, crepitations, oxygen saturation Secondary hospital admissions, length stay, re-admissions, adverse events radiological findings. Data collection analysis Two review authors independently analysed search results. Main results Five studies (543 participants) met our inclusion criteria. One study randomised 52 either ampicillin found no significant difference between groups illness. A small (21 children) higher risk potential bias proven RSV infection clarithromycin may reduce re-admission (8% versus 44% placebo; Fishers exact; P = 0.081). The (267 providing adequate data stay showed control (pooled mean 0.34; 95% CI -0.71 1.38). Two intravenous ampicillin, oral erythromycin most symptom measures. None reported deaths. Authors' conclusions This minimal evidence support use bronchiolitis. Research identify possible subgroup patients who have from failure benefit justified.