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

Abstract

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.

Pediatric flexible bronchoscopy: A single‐center report

“…The microorganisms most often isolated were H. influenzae , S. pneumoniae , and M. catarrhalis . These findings are consistent with data published by De Schutter et al 21 on children with recurrent pneumonia and by Wong et al 29 concerning children with chronic wet cough. Our results are also in keeping with the microbiological data reported by Chang et al, 24,30 who listed S. pneumoniae , H. influenzae , and M. catarrhalis as the most common microorganisms isolated in children with chronic wet cough.…”

Cough in Protracted Bacterial Bronchitis and Bronchiectasis

“…The cough score is a verbal category descriptive score (VCD) ranging from zero (no cough) to five (cannot perform most usual activities due to severe coughing) [ 47 ]. A prospective cohort study investigated if patients’ characteristics, clinical characteristics, or additional investigation results had a correlation with cough resolution [ 48 ]. This study revealed that a significant but mild relationship exists between cough duration and cough resolution.…”