Clinical and epidemiological characteristics of infants hospitalized for treatment of bronchiolitis from 2011 to 2015 in University Hospital Centre Split

CILJ ISTRAŽIVANJA: Cilj istraživanja bio je utvrditi i analizirati kliničke i epidemiološke karakteristike dojenčadi liječene u KBC Split u razdoblju od 2011. do 2015. pod dijagnozom bronhiolitisa ili akutnog opstruktivnog bronhitisa. MATERIJAL I METODE: Istraživanje je provedeno u Klinici za dječje bolesti retrospektivnom analizom medicinske dokumentacije. Prikupljanje, obrada i prikaz podataka napravljeni su u računalnom programu Microsoft Excel 2010. REZULTATI ISTRAŽIVANJA: U istraživanje je uključeno 560 ispitanika, 340 (60,71%) muške i 220 (39,29%) ženske dojenčadi. Prosječna dob dojenčadi pri prijemu iznosi 140,86±98,09 dana. Prosječna gestacijska dob iznosi 38,61±3,05 tjedana. Većina ispitanika (433/557; 77,74%) rođena je vaginalnim porodom. Pri prijemu je sekrecija iz nosa bila najčešće zabilježeni nalaz 68,39% dok je sipnja (wheezing) nađena kod 32,86%, a krepitacije kod 25,71% dojenčadi. Apneju je prije hospitalizacije imalo samo dvoje dojenčadi, a cijanoza je bila prisutna kod 16 dojenčadi (2,86%). Vrućicu je imalo 30% dojenčadi. Od ukupno 560 ispitanika kod njih 193 napravljen je test na RSV antigen. Ovaj test bio je pozitivan kod 134 (69,43%) ispitanika. U liječenju bronhiolitisa bronhodilatatori su korišteni kod 74,46%, recemični adrenalin kod 14.11%, a inhalacijski kortikosteroidi kod 24,64% ispitanika. Terapija kisikom primijenjena je kod 5% ispitanika, a antibiotska terapija primijenjena je kod njih 85,18%. Najčešće korišten anitbiotik u liječenju bronhiolitisa je ceftriakson (46,75%). Drugi po učestalosti primjene je ceftriakson u kombinaciji s azitromicinom (31,03%), a treći je azitromicin (14,26%) (N=477). Prosječna duljina hospitalizacije je 7,63±3,27 dana. ZAKLJUČCI: Usporedbom podataka dobivenih ovim istraživanjem s podatcima istraživanja provedenih u Europi i SAD-u može se primijetiti da se antibiotska terapija primjenjivala u čak 85,18% ispitanika, što je znatno veći postotak od postotka primjene u svijetu. Trebalo bi poraditi na osmišljavanju plana liječenja kojim bi se, uzimajući u svakom trenutku u obzir interes pacijenta, iznašla nova praksa koja ne bi uključivala toliko učestalu primjenu antibiotske terapije. Također, nova praksa bi trebala uzeti u obzir i podatak o duljini trajanja hospitalizacije, koji značajno odudara od podataka dobivenih u drugim zemljama. Duljina trajanja hospitalizacije mogla bi se skratiti, što bi bitno olakšalo tešku emotivnu situaciju odvojenosti dojenčeta od majke, a vrlo pozitivno bi utjecalo i na smanjenje troškova bolničkog liječenja.OBJECTIVES: The aim of this research was to determine and analyze clinical and epidemiological characteristics of infants treated in University Hospital Centre Split in period form 2011 to 2015 with the diagnosis of bronchiolitis or acute obstructive bronchitis. MATERIAL AND METHODS: This retrospective study was done at the Department of Pediatrics. The data was collected from medical charts of the enrolled subjects. Collection processing and data analysis were preformed using computer program Microsoft Excel 2010 (Microsoft, Redmond, SAD). RESULTS: This study included 560 subjects, out of which 350 (60,71%) were male and 220 (39,29%) were female infants. The average age of the infants on admission to the Hospital was 140,86±98,09 days. The average gestational age was 38,31±3,05 weeks. Majority of the participants (433/557; 77,74%) were delivered via vaginal birth. The most frequent symptom was increased nasal secretion (68,39%), followed by wheezing (32,86%) and crepitations (25,71%). Episodes of apnea were recorded in two cases and cianosis was noticed during the admission in 16 infants (2,86%). Fever was recorded in 30% of the participants. Rapid antigen based test for RSV was conducted in 193 infants. The test was proved positive in 134 (69,43%) cases. Bronchodilatators were administered in 74,46% of infants. Recemic adrenalin was used in 14,11%, while inhaled corticosteroides were used in 24,64% infants. Oxygen therapy was applied in the treatment of 5% of hospitalised infants. Antibiotic therapy was used for the treatment of 85,18% infants. Ceftriaxon was the most commonly prescribed antibiotic (46,75%). The combination of ceftriaxon and azithromycin was the second most frequent (31,03%), followed by azithromycin as the third most frequent used antibiotic (41,26%). The average lenght of hospitalization was 7,63±3,27 days. CONCLUSION: By compering the data optained in this with data from studies in Europe and the USA it can be observed that the antibiotics therapy was applied to 85,18% of the subjects, which is a considerably higher percent than the percentage of application in the rest of the world. New treatment plan should be developed that would take in to the account the best interest of the patient and provide a new practice that would not include so frequent application of antibiotic therapy. Also, a new practice should take into account the data concerning the duration of hospitalization, which signifficantly differs from the data optained in other countries. The lenght of hospitalization should be shortened which would signifficantly faciliate the difficult emotional situation of the separation of an infant from his mother and also would have a positive effect on the reduction of the cost of the hospital treatment