Efficacy of bronchodilator therapy in bronchiolitis. A meta-analysis

Arch Pediatr Adolesc Med. 1996 Nov;150(11):1166-72. doi: 10.1001/archpedi.1996.02170360056009.


Objective: To determine if bronchodilators are efficacious in treating bronchiolitis.

Data sources: A search of bibliographic databases (MEDLINE, Excerpta Medica, and Reference Update) for bronchiolitis and albuterol or ipratropium bromide, or adrenergic agents or bronchodilator agents. Reference lists were also used.

Study selection: Randomized, placebo-controlled trials of bronchodilator treatment in bronchiolitis were selected by 2 investigators. Fifteen of 89 identified publications met the selection criteria.

Data extraction: Investigators independently abstracted data for 3 outcomes: clinical score, oxygen saturation, and hospitalization. Clinical score was measured as a dichotomous variable (score +/- improved) or continuous variable (average score).

Data synthesis: For primary analysis, data were pooled from 8 trials of children with first-time wheezing. The effect size for average score was -0.32 (95% confidence interval [CI], -0.54 to -0.11; P < .01), favoring treatment; the relative risk for score +/- improved was 0.76 (95% CI, 0.60 to 0.95; P = .02), favoring treatment. Bronchodilators had no effect on hospitalization (relative risk, 0.85; 95% CI, 0.47 to 1.53; P = .58), but co-interventions may have been administered prior to this outcome. The results for oxygen saturation were too varied to allow pooling of the results. Secondary analyses were performed on 4 outpatient trials of children with first-time wheezing, 7 trials in which only nebulized beta-agonists were used, and on all 15 trials identified. The results were similar, but the data varied more.

Conclusion: Bronchodilators produce modest short-term improvement in clinical features of mild or moderately severe bronchiolitis.

Publication types

  • Clinical Trial
  • Meta-Analysis
  • Randomized Controlled Trial

MeSH terms

  • Albuterol / therapeutic use
  • Bronchiolitis / drug therapy*
  • Bronchodilator Agents / therapeutic use*
  • Child
  • Epinephrine / therapeutic use
  • Humans
  • Ipratropium / therapeutic use
  • Treatment Outcome


  • Bronchodilator Agents
  • Ipratropium
  • Albuterol
  • Epinephrine