Table 7. Acute bronchiolitis episodes in patients treated with or without antibiotics in the emergency department, after publication of the American Academy of Pediatrics clinical practice guideline on bronchiolitis [3] (periods 2 and 3, combined)a.
| Patient characteristics | No antibiotics (N = 483) | With antibiotics (N = 46) | p-value | Univariate | Multivariate | ||||
|---|---|---|---|---|---|---|---|---|---|
| n | n | OR (95% CI) | p-value | OR (95% CI) | p-value | ||||
| Age, % aged > 6 months | 483 | 198 (41.0) | 46 | 27 (58.7) | 0.02 | 2.0 (1.1 to 3.8) | 0.02 | 17.3 (5.9 to 51.2) | <0.001 |
| Age (among those > 6 months), months | 198 | 8.2 (7.3 to 9.9) | 27 | 9.4 (7.2 to 10.5) | 0.2 | 1.2 (0.9 to 1.5) | 0.1 | - | - |
| Sex, female | 483 | 212 (43.9) | 46 | 18 (39.1) | 0.5 | 0.8 (0.4 to 1.5) | 0.5 | - | - |
| Prematurity | 448 | 45 (10.0) | 43 | 4 (9.3) | 0.9 | 0.9 (0.3 to 2.7) | 0.9 | - | - |
| Personal history of atopy | 483 | 24 (4.9) | 46 | 3 (6.5) | 0.6 | 1.3 (0.4 to 4.6) | 0.6 | - | - |
| Family history of atopy | 66 | 34 (51.5) | 11 | 5 (45.4) | 0.7 | 0.8 (0.2 to 2.8) | 0.7 | - | - |
| Duration of symptoms at presentation, days | 466 | 3 (2 to 4) | 44 | 3 (2 to 5) | 0.2 | 1.1 (0.9 to 1.3) | 0.2 | - | - |
| Moderate or severe retractions | 483 | 287 (59.4) | 46 | 35 (76.1) | 0.03 | 2.2 (1.1 to 4.4) | 0.03 | - | - |
| Wheezing | 483 | 209 (43.3) | 46 | 22 (47.8) | 0.6 | 1.2 (0.6 to 2.2) | 0.6 | - | - |
| Tachypnoea | 478 | 273 (57.1) | 46 | 32 (69.6) | 0.1 | 1.7 (0.9 to 3.3) | 0.1 | - | - |
| Oxygen saturation at presentation, % | 468 | 97 (96 to 99) | 43 | 96 (93 to 97) | <0.001 | 0.8 (0.8 to 0.9) | <0.001 | - | - |
| Hospitalization | 483 | 159 (32.9) | 46 | 35 (76.1) | <0.001 | 6.5 (3.2 to 13.1) | <0.001 | - | - |
| ICU admission | 483 | 20 (4.1) | 46 | 9 (19.6) | <0.001 | 5.6 (2.4 to 13.2) | <0.001 | 4.2 (1.3 to 13.5) | 0.01 |
| Length of stay in hospitalized subjects, days | 159 | 4.3 (2.5 to 6.6) | 35 | 5.3 (3.2 to 7.8) | 0.1 | 1.1 (0.9 to 1.2) | 0.1 | 1.2 (1.1 to 1.4) | 0.003 |
| Bronchodilators before ED presentation | 483 | 75 (15.5) | 46 | 14 (30.4) | 0.01 | 2.4 (1.2 to 4.7) | 0.01 | - | - |
| Oral corticosteroids before ED presentation | 483 | 8 (1.7) | 46 | 1 (2.2) | 0.8 | 1.3 (0.2 to 10.8) | 0.8 | - | - |
| Inhaled corticosteroids before ED presentation | 483 | 5 (1.0) | 46 | 2 (4.3) | 0.06 | 4.3 (0.8 to 23.0) | 0.08 | - | - |
| Antibiotics before ED presentation | 483 | 27 (5.6) | 46 | 13 (28.3) | <0.001 | 6.6 (3.1 to 14.1) | <0.001 | - | - |
Categorical variables are reported as number (%), continuous variables are reported as median (interquartile range).
a The study periods were determined based on the publication of the American Academy of Pediatrics clinical practice guideline on bronchiolitis: [3] Period 2 immediately followed publication of the guideline and Period 3 covered year 3 post-guideline publication.