Variations in bronchiolitis management between five New Zealand hospitals: can we do better?

J Paediatr Child Health. 2003 Jan-Feb;39(1):40-5. doi: 10.1046/j.1440-1754.2003.00069.x.


Objectives: To determine the current management of bronchiolitis by five major New Zealand hospitals and to identify areas for improvement.

Methods: Lists of infants under 1 year of age admitted with bronchiolitis during 1998 were obtained from the casemix offices of the five largest New Zealand hospitals with paediatric services. Hospital records from a random sample of these admissions were reviewed.

Results: Out of the 409 infants admitted overnight, 8% had been born less than or=32 weeks gestation and 53% were aged younger than 6 months. Overall, 59% received oxygen, 21% had nasogastric fluids, 22% had intravenous fluids, 34% were prescribed antibiotics, 42% received bronchodilators and 60% had a chest radiograph. Respiratory secretions were collected for viral studies from 58% of infants and, in 59%, respiratory syncytial virus was detected. Significant variations in management were detected between hospitals. The overall proportion of infants requiring oxygen, intravenous or nasogastric fluids (65%) was significantly higher than that found in a 1986-1988 Christchurch study where only 25% received one or more of these interventions (P < 0.001).

Conclusions: Opportunities exist to rationalize bronchiolitis management in New Zealand with potential cost savings, particularly by reducing the number of chest radiographs and prescribing of unnecessary antibiotics and bronchodilators.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bronchiolitis / diagnostic imaging
  • Bronchiolitis / drug therapy
  • Bronchiolitis / therapy*
  • Bronchodilator Agents / therapeutic use
  • Evidence-Based Medicine
  • Female
  • Fluid Therapy
  • Guideline Adherence
  • Hospitals, Community / standards*
  • Humans
  • Infant
  • Infant Care / standards*
  • Infant, Newborn
  • Length of Stay
  • Male
  • New Zealand
  • Oxygen Inhalation Therapy
  • Radiography
  • Risk Factors
  • Severity of Illness Index


  • Anti-Bacterial Agents
  • Bronchodilator Agents