Use of β 2 -agonists for viral bronchiolitis

[摘要] Question A 9-month-old baby presented to my rural emergency department with 2 days of cough and congestion and 1 dayof breathing difficulties in the month of February. An auscultation examination of the lungs indicated there were scattered,faint wheezes and coarse sounds. Based on the baby’s age, symptomatology, and the winter season, the likely diagnosis wasbronchiolitis. Are inhaled b2-agonists an appropriate treatment for this patient?Answer The use of inhaled b2-agonists in children younger than 2 years of age with bronchiolitis is not indicated. Wheezingis most commonly part of the diagnosis of bronchiolitis, a lower respiratory viral infection in young children. Unlike withasthma, smooth muscle constriction in the lungs is not a symptom of bronchiolitis. Treatment of bronchiolitis requiressupportive care, but pharmaceutical interventions such as b2-agonists, steroids, and antibiotics have not been shown todecrease length of illness, illness severity, or hospitalization rates. There may be a subgroup of infants with bronchiolitis whorespond to b2-agonists treatment; however, this group has not been fully identified in the literature to date.

[学科分类] 卫生学