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Respiratory Disorders  (Expert Forum)
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Brochiolitis and antibiotics
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National Jewish -
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MedHelp Member's Question

Brochiolitis and antibiotics

by josiep, Jun 06, 2006 12:00AM
My son has had a fever for 4 days along with a cough and breathing difficulties  I took him to the emerg and had a chest x ray that showed nothing but the emerg doctor gave me a prescription for 10 days of antibiotics and no matter how many times i asked what he was treating with the antibiotics he would beat around the bush and not give me an answer  I took him to the clinic and the doctor there said he thought he had brochiolitis and said that the doctor at the hospital is a good guy and to give my son the antibiotics   i looked online and brochiolits is a virus caused by RSV and everything I have read says antibiotics do not help this form of virus and I also have read alot on the overuse of anitobiotics so i dont want to give my son one for no reason   anyone have any advice   Also isnt it a disgrace that doctors just make a diagnosis without doing any sort of testing

Doctor's Answer

by National Jewish, Jun 19, 2006 12:00AM
Acute bronchiolitis is mainly a viral disease.  Respiratory syncytial virus (RSV) causes more than 50% of cases.  Bronchiolitis can also be due to parainfluenza, adenovirus, Mycoplasma, and occasionally other viruses.  Recovery usually takes 7 to 10 days.  Antibiotics do not treat viral infections.  There is no evidence that bacteria are a cause.  However this may be followed by a bacterial infection.  Antibiotics do treat bacterial infections.  Sometimes this is confused with bacterial pneumonia.



Hospitalization is needed when there is respiratory distress.



The white blood cell and differential counts are usually normal, without the lymphopenia seen with other viral illnesses.  The utility of viral testing is debatable.
Member Comments (3)

by LLRT, Jun 10, 2006 12:00AM
There are still so many physicians doing this! I know that it is frustrating. If there in no bacteria then it is inapropriate to give antibiotics. You are correct... Bronchiolitis is a VIRAL respiratory disease that causes inflammation of the smaller airways in your childs lungs. The inflammation can trap mucus in the lungs and your child can have an increase work of breathing (retractions) because the oxygen can't cross into your child's blood stream in few areas of the lung because of the mucus. Unfortunately....THERE IS NO CURE FOR THIS DISEASE. It can progress into RSV. The only this you can do is supportive care. Bronchodilator medication is oftened prescribed to decrease the work of breating. Agressive bulb syringe suctioning must be done as often as every two hours to help keep your child's lungs clear. See your local ER and have a resp therapist teach you how to use a bulb syringe with saline to suction adequately. You also need to supply supplemental oxygen as needed. The disease has to just run it's coarse. (1-2 weeks). Keep an eye on your child because they can go downhill quickly. Breaths per minute around 70-80 for an infant-1 yr old and 60 for a 2-6 yr old should be seen in the emergency room. If your child looks mottled or blue around the lips or eyes, they should also be seen. They will then be admitted into the hospital and monitored while supplemental oxygen is given and Albuterol nebulizer tx's given with agressive suctioning. Good Luck!



Lindsay

Reg. Resp Therapist

by caregiver222, Jul 16, 2006 12:00AM
Well, there is an argument for the antibiotics. The viral infections cause the tissue to be inflamed and increases the susceptability to a bacterial infection. Bacterial infections are notorious for "piggybacking". I am not supporting or defending this line of reasoning, but it does exist, and the fact your physician prescribes antibiotics for a viral infection does not mean he/she is incompetent.
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