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Review shows paediatric protracted bacterial bronchitis needs an accurate diagnosis and strictly targeted extended
1Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.
Insights
Protracted bacterial bronchitis (PBB) is a distinct cough diagnosis. This review highlights the need for more European research on PBB, a condition often resolving with antibiotics.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- The European Respiratory Society defined protracted bacterial bronchitis (PBB) in 2017.
- Existing PBB guidelines primarily relied on data from Australia and the USA.
- A gap exists in European-specific research on PBB.
Purpose of the Study:
- To evaluate existing data on PBB.
- To address the scarcity of European research on PBB.
- To review diagnostic criteria and treatment principles for PBB in children.
Main Methods:
- A non-systematic literature review was conducted.
- The review focused on prolonged wet/productive cough and PBB in children.
- Literature search extended up to September 2018.
Main Results:
- Confirmed a significant lack of European data on PBB.
- Defined PBB as a cough lasting ≥4 weeks without specific illness pointers.
- PBB typically responds to a 2-week course of antibiotics.
Conclusions:
- Emphasized the critical need for more PBB research, particularly within Europe.
- Implementing PBB guidelines can optimize antibiotic prescribing and reduce overuse.
- Further investigation is required to understand PBB prevalence and management in European populations.
Aim:
In 2017, the European Respiratory Society task force stated that protracted bacterial bronchitis (PBB) was a distinct clinical entity and outlined the diagnostic criteria and principles for treatment. However, this guidance was based on data from Australia and the USA. This mini review evaluated the data and addressed the lack of research-based data from Europe.
Methods:
We supplemented the 2017 report by conducting a nonsystematic review of the literature on prolonged wet or productive cough and on PBB in children up to September 2018.
Results:
Our review confirmed the lack of European data on PBB. Based on the available literature, and the 2017 European guidance, PBB is a wet or productive cough that lasts for four or more weeks, with no signs or symptoms, known as specific cough pointers, which suggest an underlying illness. PBB usually recovers with appropriate antibiotics for two weeks. Failing that radiological investigations or lung function measurements are needed. If PBB occurs three times over 12 months, then computerised tomography can diagnose bronchiectasis and determine other permanent changes.
Conclusion:
More data are needed on PBB, especially in Europe. The implementation of PBB may help clinicians to prescribe antibiotics more effectively and reduce their inappropriate use.
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