Infants commonly receive antibiotics for bronchiolitis when treated in EDs

New study raises a red flag about appropriate antibiotic use

The American Academy of Pediatrics (AAP) issued guidelines more than a decade ago recommending against antibiotic treatment for bronchiolitis in infants. However, according to new research in the Journal of the Pediatric Infectious Diseases Society, antibiotics are still routinely prescribed in U.S. emergency departments (EDs) for infants who present with the common viral lung infection bronchiolitis.
 
In an analysis of CDC data on annual ED visits, researchers found that from 2007 to 2015, one-fourth of children aged 2 years and younger with bronchiolitis who were seen in U.S. EDs received an antibiotic. Among those, 70% had no documented bacterial infections. The 2006 guidelines from AAP state that antibiotic treatment for bronchiolitis in children without a documented bacterial infection is not recommended.
 
To reduce the growing threat of antibiotic resistance and promote appropriate antibiotic use, evidence-based guidelines such as those issued from AAP need to be translated more effectively into clinical practice. The study authors noted that the findings underscore the need for multicomponent quality improvement initiatives as well as a general need to continue educating health care providers and the public about appropriate antibiotic use.

They singled out nonteaching and nonpediatric hospitals as being associated with these high rates of antibiotic prescribing for infants with bronchiolitis, and suggested that these settings might benefit most from targeted quality improvement initiatives.