Frequency of protracted bacterial bronchitis and management pre‐respiratory referral

Abstract

Aim: To determine the frequency of protracted bacterial bronchitis (PBB) in children referred to tertiary care with chronic cough and describe management prior to referral. Methods: A retrospective cohort study of all new patients with a history of ≥4 weeks of cough seen at the only tertiary paediatric outpatient respiratory service in Western Australia between July 2018 and June 2019. Medical records were reviewed until a final diagnosis was documented or otherwise for a period of 18 months. Results: PBB was the most common cause and comprised 37.9% of all children referred to tertiary respiratory care with chronic cough. In children with PBB, the median cough duration at the time of first specialist review was 5.1 months (IQR 2.1-12.0 months). The most common referral source of PBB was primary practice (40.9%) and the most common working diagnosis pre-referral was asthma (15.9%). Seventy-eight percent of children with PBB had an ongoing cough at their first respiratory review, and of these, only 13.5% had been prescribed 4 weeks of antibiotics prior to their respiratory review. Asthma treatment had been prescribed for 34.0% of children with PBB. Conclusion: PBB is the most common cause of chronic cough in children referred to tertiary respiratory care and is frequently misdiagnosed and undertreated pre-referral. There is a need to facilitate diagnosis and optimal management of PBB in primary care, which could result in earlier symptom resolution and potentially limit disease progression to bronchiectasis.

Çocuklarda Fleksibl Bronkoskopi- Marmara Çocuk Göğüs Hastalıkları Deneyimi

“…Biz de çalışmamızda kronik öksürüğü olan hastaların 16'sına (%13.4) havayolu malazisi tanısı koyduk. PBB, üst merkezlere kronik öksürük nedeniyle sevk edilen hastaların en sık nedeni (%37.9) olarak tespit edilmiştir (23). Biz de kronik öksürük nedeniyle FB yaptığımızın hastalarımızın 2'sine (%1,6) PBB tanısı koyduk.…”

Protracted bacterial bronchitis: new aspects of the problem based on сlinical recommendation of the Ministry of Health of Russian Federation

“…ЗББ в основном диагностируется преимущественно в дошкольном возрасте [1][2][3][4][5][6][7][8][9][10][11][12][13]. С одинаковой частотой (28,8-30%) ЗББ отмечен у детей как младше 1 года, так и в возрастных группах 1-3 года и 3-6 лет [10].…”

“…Данная патология является наиболее частой причиной хронического кашля у детей дошкольного возраста, нередко требует междисциплинарного подхода в диагностическом плане, вызывает затруднения при выборе лечения, значительно нарушает качество жизни пациентов и их семей (нарушение сна, необходимость в проведении безрезультативного длительного лечения, пропуски занятий в школе и дошкольных учреждениях) и т. д. [2][3][4][5][6][7][8][9][10][11][12][13].…”

“…д.) морфологическим изменениям с высоким риском формирования хронической бронхолегочной патологии [1,6,[9][10][11][12][13].…”

Associated risk factors and diagnostic value of fiberoptic bronchoscopy for protracted bacterial bronchitis in children

“…Cough is one of the most common aliments in children. 1 The commonly used definition of chronic cough in children is 4 weeks, although cough in children lasting 3 to 8 weeks has been termed prolonged acute cough. 2,3 For chronic cough, prevalence is typically >10% across most surveys, ranging from 7%-33%.…”