Nebulisers ruled out for bronchiolitis in children

GPs should not use nebulisers in the treatment of bronchiolitis in children, according to guidance from SIGN.

This is the first clinical guidance of its kind in the UK. It was issued in preparation for the winter months where there is a peak prevalence of bronchiolitis.

Despite 2 per cent of all UK infants being admitted to hospital with bronchiolitis, no guidelines have been made available for treatment until now.

The SIGN guidance states that nebulised ribavirin, nebulised ipratropium and nebulised epinephrine should not be used for the treatment of infants with acute bronchiolitis. Antibiotic therapy and inhaled beta 2 agonist bronchodilators are not recommended for treatment either.

The routine use of palivizumab is not recommended but may be considered for use on a case-by-case basis in infants, less than 12 months old, with extreme prematurity or immune deficiency.

Somerset GP Dr Steve Holmes, chairman of the General Practice Airways Group, said: 'It is nice to see a review of the bronchiolitis literature that clears up the issues of whether to use nebulisers for the treatment of bronchiolitis.'

Consultant respiratory paediatrician Dr Steve Cunningham, chairman of the SIGN bronchiolitis guideline group, said that the guidelines would provide the latest evidence-driven guidance that GPs could use.

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