Authors: Jana Tuková Authors‘ workplace: Všeobecná fakultní nemocnice v Praze ; Klinika pediatrie a dědičných poruch metabolismu, 1. lékařská fakulta, Univerzita Karlova Published in: Čes-slov Pediat 2026; 81 (3): 128-131. Category: Choosing Wisely doi: https://doi.org/10.55095/CSPediatrie2026/025
Tuková J. Choosing Wisely: Management of acute bronchiolitis in children – role of corticoids and inhaled bronchodilation therapy. Focused cycle of Czech-Slovak Pediatrics according to the recommendations of the European Academy of Pediatrics
Although acute lower respiratory tract infections in infants and young children are common and serious viral diseases, there is currently no effective targeted therapy available. In clinical practice, we currently focus on preventing infection with human respiratory syncytial virus (RSV) using newly widely available passive immunization. We offer supportive therapy and monitoring to children with mild forms of the disease. In cases of developing progressive respiratory insufficiency, early hospitalization and possible therapy for respiratory failure are necessary. There is still no consensus on the use of inhaled bronchodilators and corticosteroids in the treatment of acute bronchiolitis, despite the international recommendations discouraging this therapy having been published for many years. In this article, we follow up on the Top 10 Choosing Wisely recommendations issued by the European Academy of Paediatrics in 2023, which also address the treatment of acute bronchiolitis.
corticosteroids – Choosing wisely – passive immunization – acute bronchiolitis – human respiratory syncytial virus – inhaled bronchodilators – high-flow nasal cannulas
1. Li Y, Wang X, Blau DM, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet 2022; 399(10340): 2047–64.
2. Recommendations by the European Academy of Paediatrics, Choosing Wisely 2023. Dostupné na: www.eapaediatrics.eu/advisory-groups/choose-wisely/
3. Fernandes RM, Bialy LM, Vandermeer B, et al. Glucocorticoids for acute viral bronchiolitis in infants and young children. Cochrane Database Syst Rev 2013; 2013(6): CD004878.
4. Corneli HM, Zorc JJ, Mahajan P, et al. A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N Engl J Med 2007; 357(4): 331–9.
5. Zhang XL, Zhang X, Hua W, et al. Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children. World J Pediatr 2024; 20(1): 11–25.
6. Gadomski AM, Scribani MB. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev 2014; 2014(6): CD001266.
7. Cai Z, Lin Y, Liang J. Efficacy of salbutamol in the treatment of infants with bronchiolitis: a meta-analysis of 13 studies. Medicine (Baltimore) 2020; 99(4): e18657.
8. Alansari K, Sakran M, Davidson BL, et al. Oral dexamethasone for bronchiolitis: a randomized trial. Pediatrics 2013; 132(4): e810–6.
9. Midulla F, Nenna R, Scagnolari C, et al. How respiratory syncytial virus genotypes influence the clinical course in infants hospitalized for bronchiolitis. J Infect Dis 2019; 219(4): 526–34.
10. Lin J, Zhang Y, Song A, et al. Exploring the appropriate dose of nebulized hypertonic saline for bronchiolitis: a dose-response meta-analysis. J Investig Med 2022; 70(1): 46–54.
11. Hsieh CW, Chen C, Su HC, Chen KH. Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: a meta-analysis of randomized controlled trials. BMC Pediatr 2020; 20(1): 434.
12. Hall CB, Powell KR, Schnabel KC, et al. Risk of secondary bacterial infection in infants hospitalized with respiratory syncytial viral infection. J Pediatr 1988; 113(2): 266–71.
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