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NICE hoping to reduce child admissions for bronchiolitis

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The National Institute for Health and Care Excellence has issued advice on spotting and managing bronchiolitis in babies and young children, with the aim of reducing admissions and antibiotic prescribing.

In the majority of cases, NICE noted that symptoms were mild, lasting only a few days and most children with bronchiolitis can be managed at home.

“The large majority are mild and children can be looked after comfortably in their own homes”

Gillian Leng

It said its “quality standard” on bronchiolitis recognised the importance of “arming” parents with key safety information so they knew how to keep their child comfortable at home and when to seek help.

The standard states that breathing and feeding will usually get better within five days, although a cough may take up to three weeks to go. It highlights “red flag” symptoms that parents and carers should look out for, such as disrupted breathing, exhaustion or the skin inside the child’s lips turning blue.

NICE said clinicians should advise parents and carers that bronchiolitis usually settles without the need for treatment, and that normal medicines given for a cold can be used to help ease symptoms.

The standard stressed that healthcare professionals should not prescribe antibiotics because bronchiolitis was a viral infection, in the wake of evidence they were being given to young children in UK hospitals.


Gillian Leng

NICE deputy chief executive Professor Gillian Leng said: “Antibiotics do not work, yet we are still hearing of cases where they are being prescribed.

“This needs to stop,” she said. “We want to remind healthcare professionals that reducing unnecessary use of antibiotics will help fight the threat of bacterial resistance and will also reduce costs.”

Professor Leng highlighted that admissions for bronchiolitis had risen steadily over the past two decades and it was now the third most common reason babies and young children were admitted.

“Although a small number of cases become serious, the large majority are mild and children can be looked after comfortably in their own homes,” she added.

Dr Maureen Baker, chair of the Royal College of General Practitioners, noted that bronchiolitis could be “very distressing and alarming”.

Maureen Baker

182Maureen Baker

Maureen Baker

“But most babies and young children with bronchiolitis do not require antibiotics and this guidance will help reassure parents that in the majority of cases the condition can be effectively managed at home,” she said.

“It will also support GPs and their teams who are working hard to reduce antibiotic prescribing so that they are only given to our younger patients when they really need them,” she added.

Around one in three infants will develop clinical bronchiolitis in the first year of life, and 2-3% of these will need hospitalisation.

In 2014-15 in England there were approximately 39,400 hospital admissions of children aged 0–4 with a primary diagnosis of bronchiolitis.

Of these, around 93% were aged under one year and around 7% were aged one to four years.

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