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NICE urges GPs not to prescribe antibiotics for bronchiolitis



GPs must avoid prescribing antibiotics to babies and young children with bronchiolitis, under a new NICE standard for managing the condition.

NICE said most cases of bronchiolitis – which is caused by a virus, usually respiratory syncytial virus – are mild and can be managed at home.

The standard states that ’children with bronchiolitis are not prescribed antibiotics to treat the infection’ as ‘the number of children who have bronchiolitis and who then develop a bacterial infection is extremely low’.

It adds: ‘Antibiotics can lead to common adverse reactions. Reducing unnecessary antibiotics will help prevent the development of bacterial resistance and will also reduce costs.’

NICE said GPs should advise parents that bronchiolitis usually settles without the need for treatment, although cold remedies can be used to ease symptoms. Children’s breathing and feeding will usually get better within five days, although a cough can take up to three weeks to clear up.

Red flags that indicate serious complications include disrupted breathing, exhaustion or the skin inside the child’s lips turning blue.

Dr Maureen Baker, chair of the RCGP, said: ‘Bronchiolitis can be a very nasty illness for babies and young children – and very distressing and alarming for their parents.

‘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.

‘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.’