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Chronic cough
Outcomes in children treated for persistent bacterial bronchitis
  1. Deirdre Donnelly,
  2. Anita Critchlow,
  3. Mark L Everard
  1. Paediatric Respiratory Unit, Sheffield Children’s Hospital, Western Bank, Sheffield, UK
  1. 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

Abstract

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.

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

https://doi.org/10.1136/thx.2006.058933

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    Footnotes

    • Published Online First 13 November 2006

    • Funding: DD was supported by the Sir Halley Stewart Trust

    • Competing interests: None.

    • Ethical approval: This paper describes the outcome of an audit undertaken within the respiratory team through which we wished to get a handle on the outcomes achieved by our service. In the process of the audit, it became evident that there has been nothing published on treatment and outcomes for persistent bacterial bronchitis for more than half a century, and therefore we have written up the audit for publication. Because of its origins, this was not initially submitted for ethical approval as our initial aim was simply to quantify the effectiveness of our approach and treatment outcomes.