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.