For which infants with viral bronchiolitis could it be deemed appropriate to use albuterol, at least on a therapeutic trial basis?

• Carlos E. Rodríguez-Martínez ^[5] ; Gustavo Nino ^[1] ; Jose A. Castro-Rodriguez ^[2] ; Ranniery Acuña-Cordero ^[3] ; Monica P. Sossa-Briceño ^[4] ; Fabio Midulla ^[6]
  1. [1] George Washington University

     George Washington University

     Estados Unidos

     
  2. [2] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  3. [3] Universidad Militar Nueva Granada

     Universidad Militar Nueva Granada

     Colombia

     
  4. [4] Universidad Nacional de Colombia

     Universidad Nacional de Colombia

     Colombia

     
  5. [5] Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia.
  6. [6] Department of Pediatrics, Sapienza University, Rome, Italy.

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• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 49, Nº. 1, 2021, págs. 153-158
• Idioma: inglés
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  • Although there is increasing evidence showing that infants with viral bronchiolitis exhibit a high degree of heterogeneity, a core uncertainty shared by many clinicians is with regard to understanding which patients are most likely to benefit from bronchodilators such as albuterol. Based on our review, we concluded that older infants with rhinovirus (RV) bronchiolitis, especially those with a nasopharyngeal microbiome dominated by Haemophilus influenzae; those affected during nonpeak months or during non-respiratory syncytial virus (RSV) predominant months; those with wheezing at presentation; those with clinical characteristics such as atopic dermatitis or a family history of asthma in a first-degree relative; and those infants infected with RSV genotypes ON1 and BA, have the greatest likelihood of benefiting from albuterol. Presently, this patient profile could serve as the basis for rational albuterol administration in patients with viral bronchiolitis, at least on a therapeutic trial basis, and it could also be the starting point for future targeted randomized clinical trials (RCTs) on the use of albuterol among a subset of infants with bronchiolitis.