11. NEW APPROACHES TO THE MANAGEMENT OF BRONCHIOLITIS IN CHILDREN: ABANDONING THE ROUTINE USE OF BRONCHODILATORS AND CORTICOSTEROIDS

NEW APPROACHES TO THE MANAGEMENT OF BRONCHIOLITIS IN
CHILDREN: ABANDONING THE ROUTINE USE OF BRONCHODILATORS AND
CORTICOSTEROIDS
A.R. Raıymberdieva, Abdukadyrova K.M.
Asian International University named after Satkynbai Tentishev
Department of Obstetrics, Gynecology and Pediatrics
Abstract
Background: Bronchiolitis is one of the most common lower respiratory tract diseases in
infants and young children, particularly under two years of age. The primary cause of bronchiolitis
is respiratory syncytial virus (RSV). Despite the viral nature of the disease, bronchodilators and
corticosteroids have historically been widely used in clinical practice. However, recent
international clinical guidelines and research findings indicate limited effectiveness of these
medications in typical bronchiolitis. Therefore, it is important to adopt evidence-based treatment
approaches.
Objective: To analyze current international clinical guidelines and research data on the
management of bronchiolitis in children and to evaluate the rationale for avoiding routine use of
bronchodilators and corticosteroids.
Materials and Methods: A literature review was conducted using international clinical
guidelines (AAP, NICE, Canadian Paediatric Society, ERS/ESPID) as well as studies from
PubMed and the Cochrane Library. Comparative analysis was used to evaluate the effectiveness
of bronchodilators, corticosteroids, and supportive therapy in the treatment of bronchiolitis.
Results: Analysis of current evidence shows that routine use of bronchodilators and
corticosteroids in typical bronchiolitis does not significantly improve clinical outcomes or reduce
the duration of illness and hospitalization. Additionally, these medications may cause adverse
effects such as tachycardia, tremor, and hyperglycemia. International clinical guidelines
consistently recommend supportive care as the main treatment strategy. Supportive therapy
includes oxygen supplementation, adequate hydration, and careful monitoring of the child’s
clinical condition. Prevention strategies, including monoclonal antibodies against RSV (e.g.,
nirsevimab), are considered promising for reducing severe RSV infections.
Conclusion. Current evidence-based medicine supports avoiding routine use of
bronchodilators and corticosteroids in children with typical bronchiolitis. The cornerstone of
management should be supportive therapy focused on maintaining adequate oxygenation,
hydration, and monitoring. Implementation of modern clinical guidelines and preventive
strategies against RSV infection may significantly improve outcomes and reduce severe cases of
bronchiolitis in children.
Keywords: bronchiolitis, children, respiratory syncytial virus, evidence-based medicine,
pediatric pulmonology.