1. Introduction
Bronchiolitis is the leading cause of hospital admission for respiratory
disease among infants younger than one-year-old. Clinically, children
with bronchiolitis may present with a wide range of clinical symptoms,
from mild to incipient respiratory failure1. Diagnosis
of bronchiolitis is based on clinical history and a careful physical
examination. However, clinical signs, such as rhinorrhea, cough,
dyspnea, polypnea, apnea, crackles, wheezing, and feeding difficulties,
are not specific and they significantly overlap with symptoms and signs
of other diseases2. Bronchodilators, corticosteroid,
antiviral therapy and methods of oxygen delivery have been suggested as
pharmacological interventions in treating acute bronchiolitis; however,
the evidence base for their benefit is poor3,4.
Accordingly, a previous systematic review demonstrated heterogeneous
behaviours regarding the adopted diagnostic and therapeutic approaches
adopted among several European countries, based on the panel’s
expertise5. Moreover, several aspects are still under
debate, including the choice of the best diagnostic and therapeutic
management as well as the caregivers’ adherence to validated protocols.
Therefore, significant variations in the therapeutic management of
bronchiolitis between clinicians and hospitals are often recorded, and,
in parallel, to recommend a univocal clinical approach, it is difficult
and is still questioned3-5.
Considering the significant impact of these issues, the Italian Society
of Paediatric Allergy and Immunology (SIAIP) conducted a national survey
in order to evaluate the behaviours of Italian paediatricians in the
diagnostic and therapeutic management of infants and children with acute
bronchiolitis and their adherence to the current national
recommendations1 (Table 1), also aiming to improve the
management of bronchiolitis in children and standardize the behaviour of
physicians.