{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:12:08Z","timestamp":1782349928443,"version":"3.54.5"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007636","name":"Fondation Ernst et Lucie Schmidheiny","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007636","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006388","name":"H\u00f4pitaux Universitaires de Gen\u00e8ve","doi-asserted-by":"publisher","award":["PRD 5-2017-I"],"award-info":[{"award-number":["PRD 5-2017-I"]}],"id":[{"id":"10.13039\/501100006388","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The latest guideline from the American Academy of Pediatrics for the management of bronchiolitis has helped reduce unnecessary interventions and costs. However, data on patients still receiving interventions are missing. In patients with acute bronchiolitis whose management was assessed and compared with current achievable benchmarks of care, we aimed to identify factors associated with nonadherence to guideline recommendations. In this single-centre retrospective study the management of bronchiolitis pre-guideline (Period 1: 2010 to 2012) was compared with two periods post-guideline (Period 2: 2015 to 2016, early post-guideline; and Period 3: 2017 to 2018, late post-guideline) in otherwise healthy infants aged less than 1 year presenting at the Children\u2019s University Hospitals of Geneva (Switzerland). Post-guideline, bronchodilators were more frequently administered to older (&gt;6 months; OR 25.8, 95%CI 12.6\u201352.6), and atopic (OR 3.5, 95%CI 1.5\u20137.5) children with wheezing (OR 5.4, 95%CI 3.3\u20138.7). Oral corticosteroids were prescribed more frequently to older (&gt;6 months; OR 5.2, 95%CI 1.4\u201318.7) infants with wheezing (OR 4.9, 95% CI 1.3\u201317.8). Antibiotics and chest X-ray were more frequently prescribed to children admitted to the intensive care unit (antibiotics: OR 4.2, 95%CI 1.3\u201313.5; chest X-ray: OR 19.4, 95%CI 7.4\u201350.6). Latest prescription rates were all below the achievable benchmarks of care. In summary, following the latest American Academy of Pediatrics guideline, older, atopic children with wheezing and infants admitted to the intensive care unit were more likely to receive nonevidence-based interventions during an episode of bronchiolitis. These patient profiles are generally excluded from bronchiolitis trials, and therefore not specifically covered by the current guideline. Further research should focus on the benefit of bronchiolitis interventions in these particular populations.<\/jats:p>","DOI":"10.1371\/journal.pone.0285626","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T17:32:50Z","timestamp":1684431170000},"page":"e0285626","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Factors associated with nonadherence to the American Academy of Pediatrics 2014 bronchiolitis guidelines: A retrospective study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2395-4574","authenticated-orcid":true,"given":"Laure F.","family":"Pittet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alban","family":"Glangetas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance","family":"Barazzone-Argiroffo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Gervaix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara M.","family":"Posfay-Barbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Galetto-Lacour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Stollar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"issue":"2","key":"pone.0285626.ref001","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1542\/peds.2007-1392","article-title":"Infectious disease hospitalizations among infants in the United States","volume":"121","author":"KL Yorita","year":"2008","journal-title":"Pediatrics"},{"issue":"6","key":"pone.0285626.ref002","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-2614","article-title":"Trends in bronchiolitis hospitalizations in the United States: 2000\u20132016","volume":"144","author":"M Fujiogi","year":"2019","journal-title":"Pediatrics"},{"issue":"5","key":"pone.0285626.ref003","doi-asserted-by":"crossref","first-page":"e1474","DOI":"10.1542\/peds.2014-2742","article-title":"Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis","volume":"134","author":"SL Ralston","year":"2014","journal-title":"Pediatrics"},{"issue":"Suppl 7","key":"pone.0285626.ref004","doi-asserted-by":"crossref","first-page":"S672","DOI":"10.1093\/infdis\/jiz240","article-title":"A systematic review of clinical practice guidelines for the diagnosis and management of bronchiolitis","volume":"222","author":"A Kirolos","year":"2020","journal-title":"J Infect Dis"},{"issue":"10","key":"pone.0285626.ref005","first-page":"Cd005189","article-title":"Antibiotics for bronchiolitis in children under two years of age.","author":"R Farley","year":"2014","journal-title":"Cochrane Database Syst Rev."},{"issue":"6","key":"pone.0285626.ref006","article-title":"Glucocorticoids for acute viral bronchiolitis in infants and young children.","volume":"2013","author":"RM Fernandes","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"issue":"6","key":"pone.0285626.ref007","article-title":"Bronchodilators for bronchiolitis.","volume":"2014","author":"AM Gadomski","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"pone.0285626.ref008","doi-asserted-by":"crossref","first-page":"e20170830","DOI":"10.1542\/peds.2017-0830","article-title":"Multisite emergency department inpatient collaborative to reduce unnecessary bronchiolitis care","volume":"141","author":"GM Mussman","year":"2018","journal-title":"Pediatrics"},{"issue":"2","key":"pone.0285626.ref009","doi-asserted-by":"crossref","first-page":"e2037356","DOI":"10.1001\/jamanetworkopen.2020.37356","article-title":"Trends over time in use of nonrecommended tests and treatments since publication of the American Academy of Pediatrics bronchiolitis guideline","volume":"4","author":"SA House","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"1","key":"pone.0285626.ref010","doi-asserted-by":"crossref","first-page":"e001111","DOI":"10.1136\/bmjpo-2021-001111","article-title":"Treatment for acute bronchiolitis before and after implementation of new national guidelines: a retrospective observational study from primary and secondary care in Oslo","volume":"5","author":"N Klem","year":"2021","journal-title":"Norway. 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