| dc.description.abstract | Abstract Background and Objectives Acute viral bronchiolitis is the leading cause of hospitalization in infants. Despite no evidence of its effect, the use of antibiotics in the treatment of bronchiolitis is still widespread. The aims of the present study were to identify the rate and type of antibiotic use in infants hospitalized with acute bronchiolitis in Southeast Norway, to compare this use to other countries, and to explore the association between antibiotic use and disease severity. Methods 404 infants hospitalized with moderate to severe acute bronchiolitis in eight hospitals in Southeast Norway completed a clinical trial of inhaled racemic adrenaline. The mean length of stay was 3.3 days, 44% received oxygen support, 29% nasogastric tube feeding and 7% ventilatory support. Data on the use of antibiotics has been obtained from individual patient records from all patients. Studies for comparison of antibiotic use were chosen after searching the following electronic search bases: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Medline/Pub Med. Results 8.4 % (n=34) of the patients received systemic antibiotics, (4,2% intravenous and 4,2% oral), most commonly penicillin (41%), ampicillin (26%) and gentamicin (24%). Patients treated with antibiotics stayed longer in hospital than those untreated (135.5 vs. 65.9 hours, p<0.001). Patients that received supportive therapy also received more antibiotics: oxygen (17.4% vs. 1.4%, p<0.001), feeding (15.5% vs. 5.7%, p=0.03) and ventilatory (48.3% vs. 5.3%, p<0.001) support. Use of antibiotics for bronchiolis in other studies ranged from 18 -99 %. Conclusion The use of antibiotics is substantially lower than previously reported in any geographical region. With length of stay and use of supportive care comparable to other countries, we believe the findings support a restrictive approach in bronchiolitis management | eng |