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Outcomes in children treated for persistent bacterial bronchitis
Deirdre Donnelly1, Anita Critchlow, Mark L Everard
1Paediatric Respiratory Unit, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK.
Insights
Persistent bacterial bronchitis (PBB) is often misdiagnosed as asthma. Effective antibiotic treatment resolves PBB symptoms in most children, preventing potential progression to bronchiectasis.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
Background:
- Persistent bacterial bronchitis (PBB) is frequently under-recognized and misdiagnosed, often as asthma.
- Limited data exists on PBB management and outcomes in pediatric patients.
Purpose of the Study:
- To review the outcomes of pediatric patients diagnosed with PBB.
- To highlight diagnostic and treatment challenges in PBB.
Main Methods:
- Retrospective chart review of 81 pediatric patients diagnosed with PBB.
- Diagnosis confirmed by persistent wet cough (>1 month) resolving with antibiotics.
Main Results:
- Most patients presented with persistent cough or difficult asthma, with symptom onset before age 2.
- Common pathogens included Haemophilus influenzae and Streptococcus pneumoniae.
- Over 50% of patients were symptom-free after two antibiotic courses; only 13% required six or more.
Conclusions:
- PBB is often misdiagnosed, though it can coexist with asthma.
- Antibiotic treatment resolves persistent cough and may prevent bronchiectasis.
- Further research into PBB diagnosis and treatment is essential.
Background:
Persistent bacterial bronchitis (PBB) seems to be under-recognised and often misdiagnosed as asthma. In the absence of published data relating to the management and outcomes in this patient group, a review of the outcomes of patients with PBB attending a paediatric respiratory clinic was undertaken.
Methods:
A retrospective chart review was undertaken of 81 patients in whom a diagnosis of PBB had been made. Diagnosis was based on the standard criterion of a persistent, wet cough for >1 month that resolves with appropriate antibiotic treatment.
Results:
The most common reason for referral was a persistent cough or difficult asthma. In most of the patients, symptoms started before the age of 2 years, and had been present for >1 year in 59% of patients. At referral, 59% of patients were receiving asthma treatment and 11% antibiotics. Haemophilus influenzae and Streptococcus pneumoniae were the most commonly isolated organisms. Over half of the patients were completely symptom free after two courses of antibiotics. Only 13% of patients required > or =6 courses of antibiotics.
Conclusion:
PBB is often misdiagnosed as asthma, although the two conditions may coexist. In addition to eliminating a persistent cough, treatment may also prevent progression to bronchiectasis. Further research relating to both diagnosis and treatment is urgently required.
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