Bronchiolitis: Etiology and management

Bronchiolitis is one of the most common causes of hospitalization in the first year of life. Viruses, particularly respiratory syncytial virus, are the principal causitive agents, although bacterial superinfection may occur in certain populations. Various therapeutic options, many of which are effective in asthma of older children, have been investigated for treatment of bronchiolitis in infancy. This report provides a critical review of available data on the etiology and treatment of bronchiolitis and bronchitis. Supplemental oxygen administration remains the mainstay of therapy for bronchiolitis. Available data suggest that certain infants may respond positively to inhaled β- or α-adrenergic agents, but these drugs have no effect on the rate of hospitalization or duration of illness. Corticosteroids, ipratropium, interferon, vitamin A, and respiratory syncytial virus hyperimmune globulin also seem to be ineffective. Whereas ribavirin may have minor beneficial effects, the cost of the drug precludes its use in virtually all circumstances.