Treatment options of acute viral bronchiolitis in two Iraqi pediatric hospitals with a recent montelukast treatment option.

Abstract

Bronchiolitis is a virally induced acute bronchiolar inflammation. It is the most common lower respiratory tract infection in infants with ages less than 1 year. The most common virus responsible for bronchiolitis is respiratory syncytial virus (RSV). The mainstay of management is oxygen and fluid administration. Pharmacological interventions including corticosteroids and bronchodilators have not been shown to improve outcome. Is to evaluate the effect of montelukast and to verify the efficacy of bronchodilators and anti-inflammatory drugs among infants presenting with acute viral bronchiolitis in two Iraqi pediatric hospitals. This was a randomized, prospective study in two Iraqi pediatric hospitals. Sixty infants with age range (2-24months) with a first episode of acute bronchiolitis were randomly divided into four treatment groups: oxygen plus intravenous fluid, montelukast pediatric chewable tablet, salbutamol given in combination as oral plus nebulized salbutamol, and dexamethasone IV injection. Control infants with non respiratory diseases were also studied for comparisons. The measured outcomes included: respiratory rate, heart rate, oxygen blood saturation, and times to resolution of illness, duration of oxygen & intravenous fluid therapy, and length of hospital stay. These parameters were measured for each infants from hospital admission until discharge. All groups were comparable at baseline. There are significant improvements in the respiratory rate, heart rate, blood oxygen saturation and rapid resolution of illnesses in the patients group that received oxygen plus IV fluid &the patients group that received montelukast tablet compared to other treatment options. Length of hospital stays was shorter in these two treatment options compared to other treatment options. The results observed effect of montelukast & oxygen plus intravenous fluid on the measured parameters compared to other treatments options in these two hospitals.