Perspectives Of Pediatricians And General Practitioners On Diagnosis And Treatment Of Bronchiolitis

We assessed pediatricians9 (Peds) and general practitioners9 (GPs) perspectives on managing acute bronchiolitis (AB) and its concordance with a recent national guideline (NG). The ABBA study was a Portuguese nationwide online survey with members of the Portuguese Society of Pediatrics and GPs9 mailing lists. Domains included diagnostic tests, treatments and hospital referral criteria, based on two clinical scenarios of AB severity (mild/moderate). 514 Peds and 165 GPs participated (59% specialists), 48% Peds and 44% GPs reported implementing the NG. Peds used diagnostic tests in 50%) of ≥1 bronchodilator was referred by 43% in mild and 78% in moderate AB (89% used a drug trial); salbutamol was the top choice [via spacer (40%), nebulised (32%)]. In moderate AB, frequent use of corticosteroids, adrenaline or hypertonic saline was reported by 33%, 21% and 20% Peds, respectively. The most used SpO 2 thresholds for initiating and discontinuing O 2 were 92% and 94%, respectively. Preferences of Peds between IV fluids, NG feeding were split at half. GPs referred to hospital 10% of mild and 93% of moderate AB, and up to 60% frequently used a bronchodilator. At their workplace, 34% did not have pulse oximetry and only 30% had spacers. Overall, NG recommendations were followed by 36% (diagnosis) and 12% (treatment) Peds; concordance was higher in those who reported implementing the NG (p Management of AB is heterogeneous and diverges from the NG, particularly regarding treatment. Tailored strategies are needed to implement the NG at different levels of care.