Uso de salbutamol en bronquiolitis hospitalaria

Introduction: the use of salbutamol in bronchiolitis remains widespread despite limited evidence of clinical benefit, with ongoing uncertainties regarding its effectiveness and utilization patterns in our country.Objectives: assess the use of salbutamol in bronchiolitis, its association with clinical response, patient outcomes, and associated healthcare costs.Methodology: a retrospective observational study of patients hospitalized for bronchiolitis was conducted. Salbutamol use, clinical response, intensive care unit (ICU) admission, respiratory support, length of hospital stay, and mortality were analyzed. Descriptive analyses and multivariable models adjusted for baseline severity, age, and comorbidities were performed. Cost impact was also estimated.Results: a total of 698 patients were included, of whom 600 (85,9%) received salbutamol. The clinical response rate was low, and immediate clinical deterioration was observed in a relevant proportion of patients. The clinical response rate was 6.8%; the proportion experiencing immediate post-administration deterioration was 22.7%; and the incremental cost was $U 31.2 million compared to the untreated group. Salbutamoluse was more frequent in patients presenting with higher baseline severity. In adjusted analyses, disease severity was associated with a higher likelihood of clinical response, without consistent associations for other variables. Salbutamol use was associated with higher ICU admission rates, longer length of stay, and increased resource utilization, particularly among non-responders or those experiencing clinical deterioration.Conclusions: salbutamol utilization in bronchiolitis was high and was associated with a low rate of clinical response and increased resource utilization. These findings underscore the need to avoid routine salbutamol administration and to implement deprescribing strategies, alongside improving guideline adherence and optimizing clinical practice.