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Archivos de Pediatría del Uruguay

versión impresa ISSN 0004-0584versión On-line ISSN 1688-1249

Resumen

PINCHAK, Catalina et al. Treatment modifications in patients with bronchiolitis after chest X-rays. Arch. Pediatr. Urug. [online]. 2017, vol.88, n.4, pp.189-198. ISSN 0004-0584.

Introduction:

current national guidelines recommend routine chest x-rays to patients admitted with bronchiolitis. Recent publications suggest that performing chest x-rays to all admitted infants results in low performance rates in the diagnosis of complications and leads to higher rates of antibiotic prescription.

Objectives:

to analyze chest x-ray findings in admitted patients with bronchiolitis, and to evaluate whether x-rays findings determine modifications in medical treatment. Compare the interpretation of the x-rays between clinicians and radiologists.

Method:

observational study conducted in winter 2015, in the pediatric units of two different hospitals. X-rays were independently interpreted by clinicians and by one radiologist, following a single protocol.

Results:

82 patients were included in the study. According to the radiologist, 6 % showed complications or non-consistent findings with broncholitis in the chest x-ray (atypical). Clinicians and radiologists interpretation of chest x-rays were barely coincident. Clinicians diagnosed pneumonia more frequently than imagenologists (26% vs 6%), leading to higher antibiotic prescription. Clinicians diagnosed anitbiotics in x-rays informed as typical bronchiolitis by imagenologists.

Conclusions:

chest x-ray in admitted infants with bronchiolitis were either normal or typical in 93 % of normal or typical findings. Clinicians´ and radiologists´ interpretations differed significantly. Clinicians overdiagnosed pneumonia, and thus antibiotic prescription was higher based on their x-ray interpretation.

Palabras clave : Bronchiolitis; Thoracic radiography; Anti-bacterial agents.

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