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The 2006 American Academy of Pediatrics guidelines for treatment and management of bronchiolitis do not recommend the routine use of radiographic and laboratory testing for diagnosis or the routine use of bronchodilators, epinephrine, steroids, supplemental oxygen, and antibiotics for treatment (JW Pediatr Adolesc Med Jan 10 2007). Does recent evidence support the AAP guidelines, and are we any closer to solving the mystery of bronchiolitis?
In a well-designed, randomized controlled trial (RCT), researchers compared nebulized epinephrine and oral dexamethasone, alone and in combination, with placebo in 800 full-term infants (age range, 6 weeks to 12 months) who received care for moderately severe bronchiolitis in the emergency department (ED…