Duration of amoxicillin-clavulanate for protracted bacterial bronchitis in children (DACS): a multi-centre, double blind, randomised controlled trial

Ruffles, Tom; Goyal, Vikas; Marchant, Julie M.; Yerkovich, Stephanie T.; Buntain, Helen; Cook, Anne; Schultz, André; Upham, John W.; Champion, Anita; Versteegh, Lesley; Chang, Anne B.

doi:10.1016/s2213-2600(21)00104-1

Cited by 25 publications

(20 citation statements)

References 25 publications

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“…Ruffles et al performed the first RCT to assess the duration of antibiotic treatment in children with chronic wet cough and suspected PBB, by comparing the clinical cure (cough resolution) by day 28 between 2 and 4 weeks of amoxicillin‐clavulanate. By day 28, there was no significant difference in clinical cure between the two groups, but the time to next wet cough exacerbation was significantly longer in the 4‐week group than in the 2‐week group 84 …”

Section: Other Respiratory Infectionsmentioning

confidence: 82%

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Contemporary Concise Review 2021: COVID‐19 and other respiratory infections

Chan

Hui

2022

Respirology

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Summary of key points Bats are likely the primary source of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Minks are highly susceptible to infection by SARS‐CoV‐2. Transmission from asymptomatic individuals was estimated to account for over 50% of all transmissions of coronavirus disease 2019 (COVID‐19) cases. SARS‐CoV‐2 is evolving towards more efficient aerosol transmission. Remdesivir, baricitinib, tocilizumab and dexamethasone are frequently used for the treatment of patients with respiratory failure due to COVID‐19. There is a rising incidence of non‐tuberculous Mycobacterium pulmonary disease globally, with a higher prevalence in Asian countries than in the Western world. Protracted bacterial bronchitis is a common cause of chronic productive cough in childhood. Re‐emergence of respiratory syncytial virus may occur after the relaxation of infection control measures and the reopening of borders during COVID‐19 pandemic.

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Section: Other Respiratory Infectionsmentioning

confidence: 82%

“…By day 28, there was no significant difference in clinical cure between the two groups, but the time to next wet cough exacerbation was significantly longer in the 4‐week group than in the 2‐week group. 84 …”

Section: Other Respiratory Infectionsmentioning

confidence: 99%

Contemporary Concise Review 2021: COVID‐19 and other respiratory infections

Chan

Hui

2022

Respirology

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“…Conceivably, this could reflect a series of treatment failures either due to inappropriate choice of antibiotics or inappropriate duration of antibiotics. Two recent studies that found that longer antibiotic duration can lead to a longer cough‐free period and can decrease the risk in developing recurrent infections in children 13,14 . An alternative explanation is that a recent antibiotic course could serve as a sensitive indicator for those at high risk for repeat infections, as infectious symptoms could be the presenting reason to our aerodigestive clinic.…”

Section: Discussionmentioning

confidence: 99%

Type‐1 Laryngeal Cleft and Pathogenic Bacterial Growth in the Lower Airway in Children

Ongkasuwan

Spielberg

et al. 2022

The Laryngoscope

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Objectives/Hypothesis: The purpose of this study is to evaluate the association between type-1 laryngeal clefts and pathogenic bacterial growth in the lower airway in children.Study Design: Retrospective chart review. Methods: A retrospective chart review was conducted for all children who underwent direct laryngoscopy, flexible bronchoscopy with bronchoalveolar lavage (BAL), and esophagogastroduodenoscopy, under a single anesthetic event from 2015 until 2018 at an academic tertiary referral center. Type-1 laryngeal clefts were diagnosed as an interarytenoid depth at or below the level of the vocal folds, on direct laryngoscopy, via palpation by a fellowship-trained pediatric otolaryngologist. Pathogenic bacterial growth in the lower airway was defined as presence of BAL culture growth of nonrespiratory flora.Results: A total of 217 patients were identified. Type-1 laryngeal cleft was significantly associated with chronic cough (P = .0016) and cough with feeds (P < .0001). However, an abnormal video fluoroscopic swallow study was not found to be significantly associated with type-1 laryngeal cleft (P = .92) or pathogenic bacterial growth in the lower airway (P = 0.19).Overall, 122 (56%) patients were diagnosed with type-1 laryngeal cleft, 75 (35%) had pathogenic bacterial growth in the lower airway and 50 (23%) had both type-1 laryngeal cleft and pathogenic bacterial growth in the lower airway. Type-1 laryngeal cleft was significantly associated with pathogenic bacterial growth in the lower airway on both univariate analysis (P = .0307) and multivariate analysis (P = .0298, odds ratio 1.922, 95% confidence interval 1.066-3.467).Conclusion: Children with type-1 laryngeal clefts are at higher risk of having pathogenic bacterial growth in the lower airway.

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“…All data collected are being recorded by good clinical practise trained nurse researchers on standardised data sheets as performed previously in our many RCTs (44)(45)(46). Most women and their infants are followed in their local community/region where the infants also receive their routine vaccinations following the national infant immunisation schedules for either Australia or Malaysia (Table 2).…”

Section: Data Collection Monitoring and Follow-up Detailsmentioning

confidence: 99%

Study Protocol for Preventing Early-Onset Pneumonia in Young Children Through Maternal Immunisation: A Multi-Centre Randomised Controlled Trial (PneuMatters)

et al. 2022

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Background: Preventing and/or reducing acute lower respiratory infections (ALRIs) in young children will lead to substantial short and long-term clinical benefits. While immunisation with pneumococcal conjugate vaccines (PCV) reduces paediatric ALRIs, its efficacy for reducing infant ALRIs following maternal immunisation has not been studied. Compared to other PCVs, the 10-valent pneumococcal-Haemophilus influenzae Protein D conjugate vaccine (PHiD-CV) is unique as it includes target antigens from two common lower airway pathogens, pneumococcal capsular polysaccharides and protein D, which is a conserved H. influenzae outer membrane lipoprotein.Aims: The primary aim of this randomised controlled trial (RCT) is to determine whether vaccinating pregnant women with PHiD-CV (compared to controls) reduces ALRIs in their infants' first year of life. Our secondary aims are to evaluate the impact of maternal PHiD-CV vaccination on different ALRI definitions and, in a subgroup, the infants' nasopharyngeal carriage of pneumococci and H. influenzae, and their immune responses to pneumococcal vaccine type serotypes and protein D.Methods: We are undertaking a parallel, multicentre, superiority RCT (1:1 allocation) at four sites across two countries (Australia, Malaysia). Healthy pregnant Australian First Nation or Malaysian women aged 17–40 years with singleton pregnancies between 27+6 and 34+6 weeks gestation are randomly assigned to receive either a single dose of PHiD-CV or usual care. Treatment allocation is concealed. Study outcome assessors are blinded to treatment arms. Our primary outcome is the rate of medically attended ALRIs by 12-months of age. Blood and nasopharyngeal swabs are collected from infants at birth, and at ages 6- and 12-months (in a subset). Our planned sample size (n = 292) provides 88% power (includes 10% anticipated loss to follow-up).Discussion: Results from this RCT potentially leads to prevention of early and recurrent ALRIs and thus preservation of lung health during the infant's vulnerable period when lung growth is maximum. The multicentre nature of our study increases the generalisability of its future findings and is complemented by assessing the microbiological and immunological outcomes in a subset of infants.Clinical Trial Registration:https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374381, identifier: ACTRN12618000150246.

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Duration of amoxicillin-clavulanate for protracted bacterial bronchitis in children (DACS): a multi-centre, double blind, randomised controlled trial

Cited by 25 publications

References 25 publications

Contemporary Concise Review 2021: COVID‐19 and other respiratory infections

Contemporary Concise Review 2021: COVID‐19 and other respiratory infections

Type‐1 Laryngeal Cleft and Pathogenic Bacterial Growth in the Lower Airway in Children

Study Protocol for Preventing Early-Onset Pneumonia in Young Children Through Maternal Immunisation: A Multi-Centre Randomised Controlled Trial (PneuMatters)

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