Protracted bacterial bronchitis: the last decade and the road ahead

Chang, Anne B., Upham, John W., Masters, I. Brent, Redding, Gregory R., Gibson, Peter G., Marchant, Julie M. and Grimwood, Keith (2016) Protracted bacterial bronchitis: the last decade and the road ahead. Pediatric Pulmonology, 51 3: 225-242. doi:10.1002/ppul.23351

Author Chang, Anne B.
Upham, John W.
Masters, I. Brent
Redding, Gregory R.
Gibson, Peter G.
Marchant, Julie M.
Grimwood, Keith
Title Protracted bacterial bronchitis: the last decade and the road ahead
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 1099-0496
Publication date 2016-03-01
Year available 2015
Sub-type Article (original research)
DOI 10.1002/ppul.23351
Open Access Status Not Open Access
Volume 51
Issue 3
Start page 225
End page 242
Total pages 18
Place of publication Hoboken NJ, United States
Publisher John Wiley & Sons
Collection year 2016
Language eng
Formatted abstract
Cough is the single most common reason for primary care physician visits and, when chronic, a frequent indication for specialist referrals. In children, a chronic cough (>4 weeks) is associated with increased morbidity and reduced quality of life. One common cause of childhood chronic cough is protracted bacterial bronchitis (PBB), especially in children aged <6 years. PBB is characterized by a chronic wet or productive cough without signs of an alternative cause and responds to 2 weeks of appropriate antibiotics, such as amoxicillin-clavulanate. Most children with PBB are unable to expectorate sputum. If bronchoscopy and bronchoalveolar lavage are performed, evidence of bronchitis and purulent endobronchial secretions are seen. Bronchoalveolar lavage specimens typically reveal marked neutrophil infiltration and culture large numbers of respiratory bacterial pathogens, especially Haemophilus influenzae. Although regarded as having a good prognosis, recurrences are common and if these are frequent or do not respond to antibiotic treatments of up to 4-weeks duration, the child should be investigated for other causes of chronic wet cough, such as bronchiectasis. The contribution of airway malacia and pathobiologic mechanisms of PBB remain uncertain and, other than reduced alveolar phagocytosis, evidence of systemic, or local immune deficiency is lacking. Instead, pulmonary defenses show activated innate immunity and increased gene expression of the interleukin-1β signalling pathway. Whether these changes in local inflammatory responses are cause or effect remains to be determined. It is likely that PBB and bronchiectasis are at the opposite ends of the same disease spectrum, so children with chronic wet cough require close monitoring
Keyword Airways
Bacterial bronchitis
Haemophilus influenzae
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
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