Bronchiolitis is the most common reason for hospitalization in children under the age of 2 years, resulting in a considerable burden to paediatric services. The mainstay of managing bronchiolitis is supportive through administering oxygen and fluids or feed supplements. Current research suggests that there is no definitive pharmacological treatment showing significant benefit in children with bronchiolitis and that can alter the course of the disease. Such treatments are still widely prescribed by clinicians despite limited evidence of their efficacy. This potentiates an increased likelihood of adverse side effects as well as costs to the NHS. I retrospectively reviewed 90 admissions of bronchiolitis from November 2015 to assess compliance rates with the June 2015 National Institute of Health and Clinical Excellence (NICE) guidelines on bronchiolitis management. NICE guidelines do not recommend the use of pharmacological treatments such as bronchodilators, hypertonic saline, corticosteroids, antivirals and antibiotics among others. Despite the guidelines, at our unit hypertonic saline and salbutamol was prescribed in 16% of cases, atrovent in 29%, antibiotics in 4% and steroids in 2% of cases. Nebulised adrenaline (with or without steroids) and montelukast were not prescribed at all. Thus, compliance rates of managing bronchiolitis with NICE guidelines are above 70%. Further analysis of these groups that received treatments did not reveal any identifiable patterns or trends as to why they are still being prescribed, making it more difficult to propose individualized recommendations to reduce this. Targeted educational strategies may help in improving compliance rates to guidelines.
