Treatment of acute viral bronchiolitis
| Medicine | Quality of evidence | Recommendation |
| Bronchodilators | Bronchodilators have no effect on the course of acute bronchiolitis (high)Epinephrine may have a modest effect among outpatients (moderate) | Bronchodilators should not be used routinelyIndividual trial of bronchodilators may be justified, but discontinued if no benefit is seen |
| Inhaled steroids | Inhaled corticosteroids have no effect either on the course of acute bronchiolitis (high) or on post-bronchiolitic cough and wheeze (moderate) | Inhaled corticosteroids should not be used |
| Systemic corticosteroids | Systemic corticosteroids have no or minimal effect on the course of acute bronchiolitis (high) | Systemic corticosteroids should not be used |
| Leukotriene receptor antagonists | Montelukast does not have a beneficial effect on the course of acute bronchiolitis (moderate) or on the recurrence of wheeze following acute bronchiolitis (moderate) | Montelukast should not be used |
| Immunoglobulins | Immunoglobulins have no effect on the course of acute bronchiolitis (high) | Immunoglobulins should not be used |
| Monoclonal antibodies | RSV-specific monoclonal antibodies do not alter the course of acute RSV bronchiolitis after onset of symptoms (moderate) | RSV monoclonal antibodies should not be used to treat acute viral bronchiolitis (they are used for prevention in high-risk infants) |
| Antibiotics | Antibiotics have no effect on the course of acute bronchiolitis (high) | Antibiotics should not be used |
| Antiviral treatment | There is little evidence of a positive effect of ribavirin on the course of acute bronchiolitis (moderate) | Ribavirin should not be used |
| Chest physiotherapy | Chest physiotherapy has no positive effect on the course of acute bronchiolitis (moderate) | Physiotherapy should not be used |
| Hypertonic saline | Hypertonic saline has a beneficial effect on the course of acute bronchiolitis (moderate) | Hypertonic saline should probably be used |
RSV: respiratory syncytial virus.