Regional Differences and Time Trends in the Treatment of Infants Hospitalised With Bronchiolitis in Norway.

AIMS: The Norwegian national recommendations for the evaluation and treatment of bronchiolitis were updated in 2018. Two Choosing Wisely recommendations were launched to reduce unwarranted chest X-ray, repeated blood tests and routine inhalations. The aim of this study was to evaluate adherence to the recommendations, temporal changes and differences between hospitals.

METHODS

In this multicentre retrospective study, we compared routine data from 1186 infants < 12 months of age hospitalised for bronchiolitis at five Norwegian hospitals during the winter seasons 2017-2018, 2018-2019 and 2021-2022.

RESULTS

Overall, 29% of the included infants had a chest x-ray taken with non-significant change over seasons. A decreasing proportion had more than one blood test taken over the years (60.4%, 56.6%, 43.5%; p < 0.001). The use of antibiotics (overall 4.5%), systemic steroids (2.7%) and inhalations with beta-2 agonists or adrenaline (15.4%) was generally low. The use of adrenaline decreased over the three seasons (18.1%, 10.5%, 5.2%; p < 0.001). There was a large variation in diagnostic and treatment procedures between hospitals.

CONCLUSION

Some diagnostic procedures and treatments for bronchiolitis were reduced in accordance with guidelines, but substantial variation remained between hospitals. There is a potential to further reduce the overuse of chest X-rays and repeated blood testing.