Outcomes in children treated for persistent bacterial bronchitis.
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 > or =6 courses of antibiotics.


CONCLUSIONS
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.
Donnelly
Deirdre
D
Paediatric Respiratory Unit, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK.
Critchlow
Anita
A
Everard
Mark L
ML
D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000517:prevention & control; D001991:Bronchitis / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D019818:Clavulanic Acid / Q000627:therapeutic use*; D015331:Cohort Studies; D003371:Cough / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin