Methodology of the Updated and Expanded Australasian Bronchiolitis Guideline

Kate Loveys¹, Emma J Tavender^{2

3

4}, Franz E Babl^{2

3

5}, Elizabeth Cotterell^{6

7}, Libby Haskell^{1

8}, Sharon O'Brien^{9

10

11}, Ed Oakley^{3

5

12}, Catherine Wilson², Meredith L Borland^{9

10

11}, Stuart R Dalziel^{1

8

13}; Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network

Collaborators, Affiliations

Collaborators

Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network:
Jane Alsweiler, David Armstrong, Simon Craig, Nigel Crawford, Dianne Crellin, Sonja Crone, Trevor Duke, Shane George, Christine Jeffries-Stokes, Nidhi Krishnan, Anna Lithgow, Ken Peacock, Tomas Ratoni, Peter Richmond, Annie Smith, Rebecca Starkie, David Thomas, Alexandra Wallace, Michael Zhang, Poh Chua, Marian Chandler, Paul Bauert, Christine Brabyn, Lydia Garside, David Levitt, Nicola McKay, Jocelyn Neutze, Andreas Schibler, Kam Sinn, Janine Spencer, Helen Stevens

Affiliations

¹ Department of Paediatrics: Child and Youth Health, School of Medicine, The University of Auckland, Auckland, New Zealand.
² Emergency Research, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
³ Departments of Paediatrics and Critical Care, The University of Melbourne, Parkville, Victoria, Australia.
⁴ Australian Catholic University, Sydney, New South Wales, Australia.
⁵ Emergency Department, Royal Children's Hospital, Parkville, Victoria, Australia.
⁶ Armidale Rural Referral Hospital, Armidale, New South Wales, Australia.
⁷ School of Rural Medicine and Tablelands Clinical School, University of New England, Armidale, New South Wales, Australia.
⁸ Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
⁹ Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.
¹⁰ Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia.
¹¹ Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia.
¹² Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
¹³ Department of Surgery, School of Medicine, The University of Auckland, Auckland, New Zealand.

PMID: 40673466
PMCID: PMC12397842
DOI: 10.1111/jpc.70145

Methodology of the Updated and Expanded Australasian Bronchiolitis Guideline

Kate Loveys et al. J Paediatr Child Health. 2025 Aug.

. 2025 Aug;61(8):1169-1181.

doi: 10.1111/jpc.70145. Epub 2025 Jul 17.

Authors

Collaborators

Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network:
Jane Alsweiler, David Armstrong, Simon Craig, Nigel Crawford, Dianne Crellin, Sonja Crone, Trevor Duke, Shane George, Christine Jeffries-Stokes, Nidhi Krishnan, Anna Lithgow, Ken Peacock, Tomas Ratoni, Peter Richmond, Annie Smith, Rebecca Starkie, David Thomas, Alexandra Wallace, Michael Zhang, Poh Chua, Marian Chandler, Paul Bauert, Christine Brabyn, Lydia Garside, David Levitt, Nicola McKay, Jocelyn Neutze, Andreas Schibler, Kam Sinn, Janine Spencer, Helen Stevens

Affiliations

¹ Department of Paediatrics: Child and Youth Health, School of Medicine, The University of Auckland, Auckland, New Zealand.
² Emergency Research, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
³ Departments of Paediatrics and Critical Care, The University of Melbourne, Parkville, Victoria, Australia.
⁴ Australian Catholic University, Sydney, New South Wales, Australia.
⁵ Emergency Department, Royal Children's Hospital, Parkville, Victoria, Australia.
⁶ Armidale Rural Referral Hospital, Armidale, New South Wales, Australia.
⁷ School of Rural Medicine and Tablelands Clinical School, University of New England, Armidale, New South Wales, Australia.
⁸ Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
⁹ Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.
¹⁰ Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia.
¹¹ Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia.
¹² Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
¹³ Department of Surgery, School of Medicine, The University of Auckland, Auckland, New Zealand.

PMID: 40673466
PMCID: PMC12397842
DOI: 10.1111/jpc.70145

Abstract

Background: Bronchiolitis is the most common reason for hospital admission in infants in Australia and Aotearoa New Zealand (AoNZ), with care historically affected by practice variation, including use of ineffective therapies. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) developed the first Australasian (Australia, AoNZ) bronchiolitis guideline in 2016, providing evidence-based guidance on the management of infants (< 12 months of age), presenting or admitted to hospital with bronchiolitis. In 2022, PREDICT initiated a guideline update to include new evidence and expand the scope to include intensive care (up to intubation), management of SARS-CoV-2 co-infection, and respiratory syncytial virus prevention.

Aim: This article outlines the methodology used in the guideline update, following AGREE and CheckUp reporting standards.

Methods: A Guideline Advisory Group and Guideline Development Committee, consisting of 29 clinical and methodological experts from Australasia, developed the guideline with consumer input. Forty-one scoping questions on 25 topics were investigated. Systematic searches were performed by a subject librarian across five electronic databases (last search 24/01/24). Screening of 13,932 new articles occurred independently, in duplicate in two stages. The results of 431 articles were synthesized narratively and quantitatively where appropriate, per topic. Risk of bias was evaluated using appropriate tools. GRADE methodology was used to assess evidence quality and develop the recommendations, which were finalised through consensus voting across three guideline development meetings.

Results: The update produced 41 recommendations (33 evidence-based, 8 consensus-based; including 11 new and 7 with key revisions), covering bronchiolitis investigations, management and RSV prevention. Interest-holder groups consulted on the recommendations.

Conclusion: The Australasian Bronchiolitis Guideline was updated and expanded according to AGREE and CheckUp reporting standards.

Keywords: bronchiolitis; guideline methodology; infants; paediatric; respiratory.

© 2025 The Author(s). Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

PubMed Disclaimer

Conflict of interest statement

M.L.B., S.R.D., F.E.B., S.O., and E.O.’s institutions have received equipment from Fisher and Paykel Healthcare to support bronchiolitis research. S.R.D. has received funding from Fisher and Paykel Healthcare for travel to an international meeting discussing high flow therapy. None of the authors receive any personal financial benefits from industry sponsors.

References

1. Telfar Barnard L. Z. J., “The Impact of Respiratory Disease in New Zealand: 2020 Update,” 2021.
1. Nazareno A. L., Muscatello D. J., Turner R. M., Wood J. G., Moore H. C., and Newall A. T., “Modelled Estimates of Hospitalisations Attributable to Respiratory Syncytial Virus and Influenza in Australia, 2009‐2017,” Influenza and Other Respiratory Viruses 16, no. 6 (2022): 1082–1090. - PMC - PubMed
1. Babl F. E., Sheriff N., Neutze J., Borland M., and Oakley E., “Bronchiolitis Management in Pediatric Emergency Departments in Australia and New Zealand: A PREDICT Study,” Pediatric Emergency Care 24, no. 10 (2008): 656–658. - PubMed
1. Oakley E., Brys T., Borland M., Neutze J., and Dalziel S., “Medication Use in Infants Admitted With Bronchiolitis at 7 Australian and New Zealand Centres,” Academic Emergency Medicine 21 (2014): S5–S327. - PubMed
1. O'Brien S., Borland M. L., Cotterell E., et al., “Australasian Bronchiolitis Guideline,” Journal of Paediatrics and Child Health 55, no. 1 (2019): 42–53. - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Methodology of the Updated and Expanded Australasian Bronchiolitis Guideline

Collaborators

Affiliations

Methodology of the Updated and Expanded Australasian Bronchiolitis Guideline

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous