Apego a guías clínicas para el manejo de bronquiolitis

Abstract

IntroductionThe aim of this study was to analyze the medical care of children<5 years of age with acute bronchiolitis in relation to the most relevant practices of evidence-based guidelines for bronchiolitis. MethodsWe reviewed the charts of 197 hospitalized infants with acute bronchiolitis during 2012 to 2013 to analyse whether the guideline recommendations were used according to: American Academic of Pediatritians (AAP), Scotish Intercollegiate Guidelines Network (SIGN), Sector Salud México (SS), and Guía Práctica Clínica Bronquiolitis, España (GPCBA). ResultsWe evaluated 197 patients attended by 49 pediatricians. Of the recommended actions, in 110 patients (55.8%) aspirate secretions were indicated, 105 patients (53%) received supplemental oxygen and 63 patients (31.9%) used inhaled hypertonic solution. Non-recommended actions were carried out in 166 patients (84%) who received inhaled bronchodilators, 143 patients (72%) who inhaled steroids, 110 patients (55.8%) who were prescribed antibiotics, 76 patients (38%) who had nebulization and 52 patients (26.3%) were administered systemic steroids. Physicians with<10 years of expertise prescribed more systemic steroids. ConclusionsDespite the dissemination of good clinical practice guidelines for the management of acute bronchiolitis, its adoption has not been totally completed.