Abstract：
Bronchiolitis represents one of the major causes of hospitalization and mortality in children younger than 1 year, but its management continues to be heterogenous both in those who are hospitalized and in those who are not. To assess the impact of the publication of the Italian guidelines on bronchiolitis in October 2014, we analyzed data from children aged ≤12 months admitted for bronchiolitis at the University Hospital of Pisa from January 2010 to December 2019, dividing them into two groups based on whether admission was either preceding (Group 1) or following (Group 2) the publication of the guidelines. 346 patients (mean age 4.1 ± 2.8 months, 55% males) were admitted in the study period; 43.3%, 49.4%, and 7.3% of patients had mild, moderate or severe bronchiolitis, respectively. The mean length of hospital stay was 6.7 ± 2.9 days; 90.5% of the patients underwent nasal swab and 200 patients tested positive for RSV (in mono or coinfection with other viruses). We found no difference in RSV prevalence and severity distribution between the two groups, while we observed a significant reduction in the use of both chest X-rays (66.9% vs. 34.8%, p < 0.001), blood testing (93.4% vs. 58.2%, p < 0.001) and inhaled or systemic corticosteroids (93.1% vs. 47.8%, p < 0.001) in Group 2. No significant reduction in the use of antibiotics and of inhaled β2 agonists was found. Our data suggest that the publication of the Italian guidelines for bronchiolitis has contributed to improving the management of patients admitted for bronchiolitis in our Unit.
摘要：
毛细支气管炎是1岁以下儿童住院和死亡的主要原因之一。但它的管理仍然是异质的，无论是在那些谁住院和那些谁没有。为了评估2014年10月发布的意大利细支气管炎指南的影响，我们分析了2010年1月至2019年12月在比萨大学医院接受细支气管炎治疗的≤12个月儿童的数据，根据是否在指南发布之前（第1组）或之后（第2组）将其分为两组。346例（平均年龄4.1±2.8个月，55%男性）在研究期间被录取；43.3%，49.4%,和7.3%的患者有轻度，中度或重度细支气管炎，分别。平均住院时间为6.7±2.9天；90.5％的患者接受了鼻拭子检查，200例患者的RSV检测呈阳性（与其他病毒单一或合并感染）。我们发现两组之间RSV患病率和严重程度分布无差异。而我们观察到两种胸部X光片的使用显着减少（66.9％vs.34.8%,p<0.001)，血液检测(93.4%vs.58.2%,p<0.001）和吸入或全身皮质类固醇（93.1%vs.47.8%,第2组p<0.001)。没有发现抗生素和吸入β2激动剂的使用显着减少。我们的数据表明，意大利细支气管炎指南的发布有助于改善我们单位收治的细支气管炎患者的管理。
