Health Care Epidemiology Perspective on the October 2006 Recommendations of the Subcommittee on Diagnosis and Management of Bronchiolitis

Abstract

The recent evidence-based clinical practice guideline “Diagnosis and Management of Bronchiolitis,”1 developed by the American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis and published in the October 2006 issue of Pediatrics , is a welcome comprehensive and practical tool for assisting clinicians in managing bronchiolitis in young children. In this commentary we present the views of the Pediatric Special Interest Group (PSIG) of the Society for Healthcare Epidemiology of America on several aspects of the guideline related to the management of children who are hospitalized with bronchiolitis. Established in October 2006, the PSIG comprises pediatric infectious-disease physicians and infection-control professionals who have expertise in pediatric health care epidemiology and infection control. The PSIG requests that the American Academy of Pediatrics subcommittee clarify and reconsider its recommendations regarding the target population for the guideline, viral diagnostic testing, and interventions for preventing transmission of respiratory syncytial virus (RSV) and other viral agents that are associated with bronchiolitis, especially in inpatient settings. Although it was stated that the guideline applies to the management of bronchiolitis in healthy children, it is important to note that the absence of an identified underlying condition does not necessarily imply that hospitalized children with bronchiolitis are otherwise healthy. Severe bronchiolitis may be an … Address correspondence to Jo-Ann S. Harris, MD, Division of Infectious Disease, Pediatric Special Interest Group of the Society for Healthcare Epidemiology of America, Department of Pediatrics, MS 4004, 3901 Rainbow Blvd, Kansas City, KS 66160. E-mail: jharris7{at}kumc.edu