Outcomes in protracted bacterial bronchitis (PBB): a five year prospective cohort study
| Autor: | Simpson Jodie, Sandra Hodge, Peter G. Gibson, Julie M. Marchant, John W. Upham, Susan J. Pizzutto, Danielle Wurzel, Greg Hodge, Katie Baines, Ian Brent Masters, Stephanie T. Yerkovich, Greta Busch, Helen M. Buntain, Thomas Ruffles, Anne B. Chang |
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| Rok vydání: | 2018 |
| Předmět: |
Spirometry
Pediatrics medicine.medical_specialty Bronchiectasis medicine.diagnostic_test business.industry Incidence (epidemiology) medicine.disease 03 medical and health sciences Chronic cough 0302 clinical medicine 030228 respiratory system Bronchoscopy medicine 030212 general & internal medicine Bronchomalacia medicine.symptom business Prospective cohort study Asthma |
| Zdroj: | Paediatric respiratory infection and immun.. |
| Popis: | Introduction: Protracted bacterial bronchitis (PBB), the commonest cause of chronic cough in childhood, is characterised by chronic wet cough (>4 weeks duration) that usually responds to 2-wks of appropriate antibiotic therapy without evidence of an alternative cause for cough. There are no long term studies on PBB beyond 2 yrs. Objectives: Characterise the 5 yr outcomes for children with PBB. Methods: 151 children (median age 26-mo, range 4-163) requiring bronchoscopy (FB) were recruited (PBB=130, controls=21). Participants were followed up for 5 yrs (min 42 mo). Participants were monitored with monthly contact via research staff and when possible annual clinical review and spirometry. CT chest was performed if symptoms/signs suggestive of bronchiectasis were present. Asthma was defined as a doctor diagnosis. Results: Of the 130 children with PBB, 88 (68%) had trachea/bronchomalacia on FB. CT chest was performed on 59 children (max 28 mo post FB), 11 (8.5%) had bronchiectasis. The incidence of recurrent PBB (>3 episodes/yr) decreased over study time from 70 (53.8%) in Yr-1 to 8 (15.7%) in Yr-5. However 38 (60.3%) required at least one course of antibiotics for an episode of wet cough in the preceding year. At the Yr-5 evaluation, 34 children with PBB (45.9%) had a diagnosis of asthma vs 2 (14%) in the controls (p Conclusion: Children with PBB should be followed-up as a significant proportion will eventually develop bronchiectasis and/or an asthma phenotype. Identifying clinical and/or lab-based markers (e.g. molecular signatures) at the index PBB episode would be useful for predicting future risk of disease. |
| Databáze: | OpenAIRE |
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