Anales españoles de pediatría
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Bronchiolitis is the leading cause of lower respiratory tract infection in infants and produces significant morbidity. Limited progress has been made in the treatment of this disease and, in many cases, the therapy employed is controversial and mainly based on general recommendations and not on evidence-based strategies. This report uses evidence-based methodology to provide a critical review of the data available on the treatment of acute bronchiolitis (understood as the first episode of respiratory syncytial virus bronchiolitis in a previously healthy infant). ⋯ Other therapies such us physiotherapy, nebulization, heliox, anticholinergics or exogenous surfactant, among others, require further randomized controlled trials to determine their utility. No evidence supports the routine use of corticosteroids, beta-adrenergic drugs, antibiotics, immunoglobulins, interferon, vitamin A or ribavirin in these patients. Finally, we consider that a national consensus review for the implementation of evidence-based clinical practical guidelines on the management of acute bronchiolitis would be of great interest.
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Bronchiolitis is the most frequent respiratory tract disease in the first 2 years of life. It occurs in epidemics in winter and spring. Etiology is viral and the most frequent causative agent is respiratory syncytial virus. ⋯ The present study provides a review of the medical literature on the most commonly used clinical scores and the therapeutic efficacy of the different drugs employed. A protocol for the practical management of bronchiolitis is provided. The use of inhaled adrenaline in the treatment of moderate-to-severe bronchiolitis in hospitalized infants, as well as oxygen and fluid therapy as support measures, are recommended.
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Comparative Study
[Procalcitonin in the early diagnosis of invasive bacterial infection in febrile infants].
Procalcitonin (PCT) it is a new marker of bacterial infection. Because of its shorter half-life and earlier ascent it offers advantages over C-reactive protein (CRP). ⋯ The diagnostic performance of PCT was higher than that of CRP in the early detection of invasive infection in febrile infants, even when evolution was less than 12 hours.