Outcomes in Children Treated for Persistent Bacterial Bronchitis

Deirdre Donnelly ¹, Anita Critchlow ¹ and Mark L Everard ^1*

¹ Sheffield Children's Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: m.l.everard{at}sheffield.ac.uk.

Accepted 14 October 2006

Abstract

Background: Persistent bacterial bronchitis [PBB] appears to be under recognized and frequently mis- diagnosed 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 made on the standard criteria of a persistent, wet cough present for greater than 1 month that resolves with appropriate antibiotic therapy.

Results: The commonest reason for referral was a persistent cough or 'difficult asthma'. In the majority of subjects symptoms commenced before the age of 2 years and had been present for more than one year in 59% of subjects. At referral 59% were on asthma treatment and 11% on antibiotics. H influenzae and Strep pneumoniae were the most commonly isolated organisms. Over half of patients were completely symptom free after two courses of antibiotics. Only 13% required 6 or more courses of antibiotics.

Conclusion: PBB is frequently misdiagnosed as asthma, though the two conditions may co-exist. 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.

Keywords: Asthma, Bronchiectasis, Cough, Persistent bacterial bronchitis, Treatment

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