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Inpatient Antibiotics

Bronchiolitis team recommendation: Based on high quality evidence, the Bronchiolitis CPG Team recommends that antibiotics not be used routinely for the child who presents for the first time with the symptoms of bronchiolitis. The presence of secondary infection should be treated appropriately. The recommendation is based on the Cochrane Database of Systematic Reviews (CDSR) by Spruling, Doust, Del Mar and Eriksson (2011).  It included five studies- two high quality and three of moderate quality. The use of antibiotics did not affect duration of symptoms, (at three days) length of stay for inpatients, re-admission rate or deaths.

Literature supporting this recommendation:  Ninety-five citations were located by the PubMed search, no unique articles were added by the CINAHL search and one CDSR was located. The CDSR by Spurling, 2011 is included in this review. No single studies published since the CDSR were identified that answered this question.

Critically Appraised Topic (CAT): Antibiotics

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.