CHRONIC COUGH

Outcomes in children treated for persistent bacterial bronchitis

Deirdre Donnelly, Anita Critchlow, Mark L Everard

Paediatric Respiratory Unit, Sheffield Children’s Hospital, Western Bank, Sheffield, UK

Correspondence to:
Dr M L Everard
Paediatric Respiratory Unit, Sheffield Children’s Hospital, Western Bank, Sheffield S10 2TH, UK; m.l.everard{at}sheffield.ac.uk

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 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.

Abbreviations: HRCT, high-resolution computed tomography; LRTI, lower respiratory tract infection; PBB, persistent bacterial bronchitis; PCD, polycystic disease

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• Bush, A. (2009). Update in Pediatric Lung Disease 2008. Am. J. Respir. Crit. Care Med. 179: 637-649 [Full Text]  
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