Management of Pediatric Bronchitis

Diagnosis and Treatment

The American Academy of Pediatrics recommends that bronchiolitis is a clinical diagnosis based on history and physical examination alone, and do not routinely order chest radiographs, viral testing, or laboratory studies 2, 3, 4, 1
Characterized by rhinitis, cough progressing to tachypnea, wheezing, rales, and increased work of breathing in infants 1-23 months, with a strong recommendation for supportive care alone 2
Administer supplemental oxygen only if SpO2 persistently falls below 90%, and maintain SpO2 ≥90% with standard oxygen delivery, as recommended by the American Academy of Pediatrics 2, 3, 4, 1
The American Academy of Pediatrics recommends against the routine use of bronchodilators, corticosteroids, and antibiotics, as they lack evidence of benefit 2, 3, 4, 1

The European Respiratory Society recommends that for acute respiratory exacerbations, use a 14-day course of appropriate systemic antibiotics, and for recurrent exacerbations, use long-term macrolide antibiotics for at least 6 months 5
Teach and provide regular airway clearance techniques individualized to age and development, as recommended by the European Respiratory Society 5

The American Academy of Pediatrics recommends palivizumab prophylaxis for high-risk infants, with 5 monthly doses (15 mg/kg IM) starting November/December, to reduce the risk of hospitalization due to respiratory syncytial virus (RSV) infection 2, 4
Promote breastfeeding, as it reduces hospitalization risk by 72%, and avoid tobacco smoke exposure, as recommended by the American Academy of Pediatrics 3, 4