Does failed chronic wet cough response to antibiotics predict bronchiectasis?

Goyal, Vikas, Grimwood, Keith, Marchant, Julie, Masters, I Brent. and Chang, Anne B. (2014) Does failed chronic wet cough response to antibiotics predict bronchiectasis?. Archives of Disease in Childhood, 99 6: 522-525. doi:10.1136/archdischild-2013-304793

Author Goyal, Vikas
Grimwood, Keith
Marchant, Julie
Masters, I Brent.
Chang, Anne B.
Title Does failed chronic wet cough response to antibiotics predict bronchiectasis?
Journal name Archives of Disease in Childhood   Check publisher's open access policy
ISSN 1468-2044
Publication date 2014-06-01
Year available 2014
Sub-type Article (original research)
DOI 10.1136/archdischild-2013-304793
Volume 99
Issue 6
Start page 522
End page 525
Total pages 4
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Formatted abstract
Aim To determine whether a child with chronic wet cough and poor response to at least 4 weeks of oral antibiotics is more likely to have bronchiectasis.

Methods All chest multi-detector computerised tomography (MDCT) scans at a single paediatric tertiary hospital from April 2010 to August 2012 were reviewed retrospectively so as to identify those ordered by respiratory physicians for assessment of children with a chronic wet cough. Information regarding age, sex, ethnicity, indication for imaging and the response to at least 4 weeks of antibiotics before having the scan were recorded from their charts. The data were analysed using simple and multiple logistic regression.

Results Of the 144 (87 males) eligible children, 106 (65 males, 30 Indigenous) aged 10–199 months had MDCT scan evidence of bronchiectasis. Antibiotic data were available for 129 children. Among the 105 children with persistent cough despite at least 4 weeks of antibiotics, 88 (83.8%) had bronchiectasis, while of the 24 children whose cough resolved after antibiotics, only six (25.0%) received this diagnosis (adjusted OR 20.9; 95% CI 5.36 to 81.8). Being Indigenous was also independently associated with radiographic evidence of bronchiectasis (adjusted OR 5.86; 95% CI 1.20 to 28.5).

Conclusions Further investigations including a MDCT scan should be considered in a child with a chronic wet cough that persists following 4 weeks of oral antibiotics. However, while reducing the likelihood of underlying bronchiectasis, responding well to a single prolonged course of antibiotics does not exclude this diagnosis completely
Keyword Bronchiectasis
Chronic wet cough
Oral antibiotics
Multi-detector computerised tomography
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Queensland Children's Medical Research Institute Publications
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
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