P553 Impact of the international guidelines on the therapy of bronchiolitis: single-centre retrospective analysis

The AAP bronchiolitis guidelines published in 2006 and updated in 2014 recommended supportive care with limited diagnostic testing and treatment. To comply with the international guidelines in 2014 we’ve started a campaign to improve the therapeutic practice of bronchiolitis at our hospital. Aim To assess the effect of the therapeutic regime changes on the morbidity of bronchiolitis (need of PICU transmission, length of hospital stay) at our hospital. Methods The data of 225 patients, aged 1–12 months, hospitalized in the period of April to October between 2013 and 2018 with the diagnosis of bronchiolitis at our Pulmonology Unit was analysed retrospectively. Results Antibiotic treatment application decreased since 2013 in each year (In 80%–36%–27%–12%–2% of the patients respectively). Same as the antibiotic use, the systemic corticosteroid and inhalative B2 agonist administration decreased significantly (60% – 28% – 17% – 2% – 0% and 80% – 39% – 40% – 13% – 14% of the cases). Use of 3% saline inhalation increased: 30% – 39% – 93% – 93% – 95%. Although the use of drug therapies decreased during the observational period, it did not cause an increase either in the length of hospital stay (median days 6.4 – 6.3 – 6.9 – 4.5 – 5.0) or in PICU transmissions (patients/observational period 2 – 3 – 4 –2 –1). Conclusion Aplying the international guidelines in to everyday-life practice did not result in increased morbidity. Besides there was a positive effect on cost effectivity and patient comfort.