In the last 2 years in Italy and in the world there have been heavy epidemics of bronchiolitis which have put health systems in difficulty due to the saturation of beds in the wards and in intensive care units. Most hospitalizations concern infants in their first year of life. The main etiologic agent of bronchiolitis is respiratory syncytial virus (RSV); it is estimated that this virus infects more than 60% of children during the first year of life. Today Italy, in order to contrast this virus which has put Italian pediatricians in trouble also due to the concomitance with the flu epidemic and Sars-CoV-2, is adopting new guidelines that aim for uniformity and standardization treatments and correct information to parents.
The scientific publication reiterates that “drugs for which there is no evidence are often used and that these drugs can also cause side effects – explains Eugenio Baraldi, director of the women’s and children’s health department of the University of Padua hospital – “Drugs such as cortisone, antibiotics and bronchodilators shouldn’t be used, while this still happens often. The Guidelines emphasize the importance of providing information to the parents of small children to prevent infection – he reiterates – because in bronchiolitis one of the fundamental aspects is that of prevention, since, in addition to oxygen, there are neither antivirals nor vaccines available”.
The guidelines, created with the aegis of the Italian Society of Pediatrics (Sip), the Society of Neonatology (Sin), the Society for Infantile Respiratory Diseases (Simri) and 13 other pediatric scientific societies, have just been published in the Italian Journal of Pediatrics and update those of 2014, in the light of the latest scientific evidence.
Staiano, ‘it is important to provide pediatricians with the best practices for the management of bronchiolitis’
“This document – underlines the president of the Italian Society of Pediatrics Annamaria Staiano, one of the authors of the paper – is published at a time when the health service has been put to the test due to this virus. It is therefore important to provide pediatricians who work in the area, in hospitals and emergency rooms, with an update on best practices for the management of bronchiolitis with the hope of arriving at a common and shared medical approach”.
Therapies, as novelties to prevent the syncytial virus. “From the point of view of pharmacological prevention, there is a monoclonal antibody for RSV already available, Palivizumab*, which has been used for many years to protect infants born prematurely. A novelty that is entering the market is a new monoclonal antibody which it could be given to all infants for universal prophylaxis. Such a strategy could contain seasonal RSV epidemics and the number of hospitalizations. There are also several vaccines under study, but they are more distant in reaching the clinic, application “, concludes Sip.
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