Bronchiolitis: from empiricism to scientific evidence.

Bronchiolitis is the most common viral infection of the lower respiratory tract in infants in their first year of life, with an incidence peak between 3 and 9 months of age. The clinical profile of bronchiolitis results from the inflammatory obstruction of the small airways. The etiological agent involved is respiratory syncytial virus (RSV) in more than 50% of cases. The first international guidelines on the management of children with bronchiolitis have recently been published. The first was produced by a special subcommittee created by the American Academy of Pediatrics (AAP) with the support of a few important international associations that deal with respiratory diseases including the American Thoracic Society and the European Respiratory Society; the second was drawn up by the Scottish Intercollegiate Guidelines Network (SIGN). This review sets out to update the management of children with bronchiolitis by discussing the salient points relating to diagnosis, treatment and prevention on the basis of the recommendations in these documents.