Antibiotics for prolonged wet cough in children

Marchant, Julie M.; Petsky, Helen; Morris, Peter S.; Chang, Anne B.

doi:10.1002/14651858.cd004822.pub3

Cited by 20 publications

(21 citation statements)

References 57 publications

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“…[12][13][14][15] The recommendation is based on systematic reviews that include three randomized controlled trials (RCTs). [16][17][18] However, the optimal duration of antibiotics is unknown with guidelines recommending varying duration from 2 weeks (extending to 4 weeks if the wet cough does not resolve 6,18 ) to 4 to 6 weeks at the first presentation. 12 It is known that longer cough duration is associated with worse radiological abnormality (defined on high-resolution computed tomography [HRCT]) and structural airway lesions in children.…”

mentioning

confidence: 99%

Predictors of time to cough resolution in children with chronic wet cough treated with antibiotics after bronchoscopy

Wong

Marchant

Yerkovich

et al. 2019

Pediatric Pulmonology

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Background Chronic wet cough is common in pediatric pulmonology practice and is clinically important. Guidelines recommend treatment with antibiotics as their effectiveness has been proven. However, factors associated with duration of cough in response to antibiotics in children with chronic wet cough have not been prospectively examined. Objective To determine if demographic, clinical and/or bronchoalveolar lavage (BAL) factors are associated with “time to cough resolution” in children with chronic wet cough treated with antibiotics after bronchoscopy. Methods Data from children with chronic wet cough treated with antibiotics after bronchoscopy were extracted from a prospective cohort study database. Cough dairies were used to determine when the cough resolved. Associations between various factors with “time to cough resolution” were examined using regression. Results The median age of the 133 children was 2.4 years (interquartile range, 1.4‐4.9). Duration of prior cough at bronchoscopy was significantly positively related with “time to cough resolution” (β = .010; 95% confidence interval, 0.004‐0.017; P = .002). This translated to; for each month of prior cough, it took an extra 1.02 days to achieve cough resolution while on antibiotic treatment. Gender, age, diagnosis, tobacco smoke exposure, pneumonia history, blood cellularity, and BAL cellular and microbiology profiles were not significantly associated with time to cough resolution. Conclusion In children with chronic wet cough, duration of cough before antibiotic treatment is a small but significant determinant of “time to cough resolution.” Research using standardized antibiotic regimes is required to provide clinical and/or biomarkers that can further identify factors associated with the response of chronic cough to antibiotic treatment.

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mentioning

confidence: 99%

Predictors of time to cough resolution in children with chronic wet cough treated with antibiotics after bronchoscopy

Wong

Marchant

Yerkovich

et al. 2019

Pediatric Pulmonology

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“…Two studies were classified as low risk of bias . One was at risk of detection bias due to inadequate blinding of personnel, participants and outcome assessors …”

Section: What Are the Findings Based On?mentioning

confidence: 99%

“…Comparison of antibiotics versus no antibiotics for wet cough in children and outcomes of children not cured or not substantially improved at follow‐up. (Reproduced from Marchant et al, with permission.) CI, confidence interval.…”

Section: What Are the Findings Based On?mentioning

confidence: 99%

“…Antibiotics effective against these pathogens treat the condition through bacterial eradication. An assessment needs to be undertaken to differentiate post‐viral or subacute cough from protracted bacterial bronchitis and other more serious causes of cough, including bronchiectasis, cystic fibrosis, recurrent aspiration and infection due to immunodeficiency or inhaled foreign body . Signs that suggest an alternate diagnosis include persistent chest signs on auscultation, recurrent sinopulmonary infections, haemoptysis, failure to thrive, clubbing, nasal polyps or chest wall deformity.…”

Section: Clinical Perspectivementioning

confidence: 99%

“…Protracted bacterial bronchitis may lie within the same disease spectrum as bronchiectasis, the latter occurring in the setting of delayed antibiotic therapy and resulting in significant morbidity and mortality. The authors of this Cochrane review noted that the studies included in this meta‐analysis included participants whose symptomatology did not meet the current definition of chronic cough. As the studies were performed when the definition of chronic cough was of shorter duration, a decision was made by the Cochrane authors to include these studies in the meta‐analysis.…”

Section: Clinical Perspectivementioning

confidence: 99%

See 2 more Smart Citations

Antibiotics for prolonged wet cough in children

Prentice

Jaffé

2019

J Paediatrics Child Health

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Otolaryngologic Management of Chronic Cough in School-aged Children

Kennedy

Anne

Hart

2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEThe causes of pediatric chronic cough are numerous and span across several medical subspecialties. In addition to the vast array of underlying causes, there are also several different ways to approach and evaluate chronic cough. Given the frequency with which children present to otolaryngology clinics with this problem, a review of common otolaryngologic causes and an algorithm for evaluation and treatment can be beneficial.OBSERVATIONS The primary 3 causes of pediatric chronic cough presenting to an otolaryngologist include infectious causes, reflux, and airway hyperreactivity. In these cases and other instances of specific cough, treatment should be directed at the underlying cause-which may include supportive care, antibiotics, antireflux medication, bronchodilators, inhaled steroids, or other intervention. Patients with nonspecific cough should be treated according to pediatric-specific cough algorithms.CONCLUSIONS AND RELEVANCE Appropriate workup and treatment of chronic cough can lead to higher cure rates, shorter cough duration, and improved quality of life for both patients and caregivers. A systematic approach using cough algorithms can help otolaryngologists effectively manage this common yet complex problem.

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Antibiotics for prolonged wet cough in children

Cited by 20 publications

References 57 publications

Predictors of time to cough resolution in children with chronic wet cough treated with antibiotics after bronchoscopy

Predictors of time to cough resolution in children with chronic wet cough treated with antibiotics after bronchoscopy

Antibiotics for prolonged wet cough in children

Otolaryngologic Management of Chronic Cough in School-aged Children

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