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Duration of initial antibiotic course is associated with recurrent relapse in protracted bacterial bronchitis

Ellen Gross-Hodge1, Will D Carroll2, Naomi Rainford3

  • 1Institute of Applied Clinical Science, Keele University, Keele, UK.

Archives of Disease in Childhood
|October 19, 2019
PubMed

Insights

Protracted bacterial bronchitis (PBB) in children may be prevented from recurring by extending initial antibiotic treatment. A 6-week course, compared to 2 weeks, significantly reduced recurrent PBB episodes and potential bronchiectasis development.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Protracted bacterial bronchitis (PBB) is a primary cause of chronic wet cough in children.
  • Current treatment guidelines lack evidence for optimal antibiotic duration, leading to practice variability.
  • Recurrent PBB is linked to an increased risk of developing bronchiectasis.

Purpose of the Study:

  • To identify factors associated with relapse and recurrence of PBB in children.
  • To investigate the impact of initial antibiotic treatment duration on PBB recurrence.
  • To explore the relationship between PBB recurrence and the development of bronchiectasis.

Main Methods:

  • Retrospective analysis of 66 children diagnosed with PBB.
  • Evaluation of factors linked to any relapse (≥1 episode/12 months) and recurrent PBB (>3 episodes/12 months).
  • Comparison of outcomes between children receiving 2-week versus 6-week initial antibiotic courses.

Main Results:

  • No specific factor was significantly associated with any PBB relapse.
  • Initial antibiotic treatment duration was the sole significant factor associated with recurrent PBB.
  • Children receiving a 6-week antibiotic course had a lower likelihood of recurrent PBB compared to those receiving a 2-week course (p=0.046).

Conclusions:

  • Longer initial antibiotic treatment duration may reduce the recurrence of PBB in children.
  • This study suggests a potential link between initial antibiotic course length and the future risk of bronchiectasis.
  • Further prospective research is warranted to confirm these findings and inform optimal PBB treatment strategies.

Keywords:
bacterial infectionbronchiectasiscoughpaediatric lung diseaserespiratory infection

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