Journal of Clinical Pediatrics >
Current status of diagnosis and treatment of protracted bacterial bronchitis in children
Received date: 2023-01-04
Online published: 2024-04-09
Protracted bacterial bronchitis (PBB) is a persistent infectious disease of the bronchial intima caused by bacteria. PBB is the leading cause of chronic cough in children at home and abroad. At present, it has been included in the guidelines for chronic cough in many countries and has been improved and updated. The diagnosis of PBB includes clinical diagnostic criteria and microbiology-based diagnostic criteria. Currently, amoxicillin-clavulanate potassium is recommended as the first choice for the treatment of PBB. When children are allergic to penicillin or resistant to amoxicillin-clavulanate potassium, cephalosporins or macrolides can be selected. Although cough relief after 2 weeks of appropriate antibiotic treatment is a critical part of the diagnosis of PBB, there is currently no consensus on the optimal course of antibiotics treatment. The prognosis of PBB is generally good, but frequent recurrence and repeated antibiotic use are common. There is also a risk of progression to bronchiectasis if PBB is recurrent and associated with Haemophilus influenzae infection. Up to now, the understanding of PBB in China started relatively late, and there are still deficiencies in diagnosis and treatment. In order to standardize PBB diagnosis and therapy, this article primarily presents the current state of PBB diagnosis and treatment and highlights issues that still need to be resolved in this area.
Juan LI , Jihong DAI . Current status of diagnosis and treatment of protracted bacterial bronchitis in children[J]. Journal of Clinical Pediatrics, 2024 , 42(4) : 373 -378 . DOI: 10.12372/jcp.2024.22e1723
| [1] | Prime SJ, Carter HE, McPhail SM, et al. Chronic wet cough in Australian children: societal costs and quality of life[J]. Pediatr Pulmonol, 2021, 56(8): 2707-2716. |
| [2] | Laird P, Ball N, Brahim S, et al. Prevalence of chronic respiratory diseases in Aboriginal children: a whole population study[J]. Pediatr Pulmonol, 2022, 57(12): 3136-3144. |
| [3] | 中华医学会儿科学分会呼吸学组慢性咳嗽协作组,《中华儿科杂志》编辑委员会. 中国儿童慢性咳嗽诊断与治疗指南(2013年修订)[J]. 中华儿科杂志, 2014, 52(3): 184-188. |
| [4] | Li Q, Guo Z, Li Y, et al. Diagnosis and management of protracted bacterial bronchitis: a survey of Chinese pediatricians[J]. Ann Transl Med, 2021, 9(1): 46. |
| [5] | Ruffles TJC, Marchant JM, Masters IB, et al. Outcomes of protracted bacterial bronchitis in children: A 5-year prospective cohort study[J]. Respirology, 2021, 26(3): 241-248. |
| [6] | Lau GTY, Laird P, Stevenson PG, et al. Frequency of protracted bacterial bronchitis and management pre-respiratory referral[J]. J Paediatr Child Health, 2022, 58(1): 97-103. |
| [7] | Chang AB, Marchant JM. Protracted bacterial bronchitis is a precursor for bronchiectasis in children: myth or maxim?[J]. Breathe (Sheff), 2019, 15(3): 167-170. |
| [8] | Chang AB, Upham JW, Masters IB, et al. Protracted bacterial bronchitis: the last decade and the road ahead[J]. Pediatr Pulmonol, 2016, 51(3): 225-242. |
| [9] | Wurzel DF, Marchant JM, Yerkovich ST, et al. Protracted bacterial bronchitis in children: natural history and risk factors for bronchiectasis[J]. Chest, 2016, 150(5): 1101-1108. |
| [10] | Marchant JM, Masters IB, Taylor SM, et al. Evaluation and outcome of young children with chronic cough[J]. Chest, 2006, 129(5): 1132-1141. |
| [11] | 中华医学会儿科学分会呼吸学组慢性咳嗽协作组, 儿童慢性湿性咳嗽病因构成比研究协作组. 儿童慢性湿性咳嗽病因构成比多中心研究[J]. 中国实用儿科杂志, 2019, 34(9): 757-762. |
| [12] | Marsh RL, Binks MJ, Smith-Vaughan HC, et al. Prevalence and subtyping of biofilms present in bronchoalveolar lavage from children with protracted bacterial bronchitis or non-cystic fibrosis bronchiectasis: a cross-sectional study[J]. Lancet Microbe, 2022, 3(3): e215-e223. |
| [13] | Marsh RL, Smith-Vaughan HC, Chen ACH, et al. Multiple respiratory microbiota profiles are associated with lower airway inflammation in children with protracted bacterial bronchitis[J]. Chest, 2019, 155(4): 778-786. |
| [14] | Ntesou D, Douros K, Tsiambas E, et al. Impact of immune-inflammatory microenvironment alterations on the bronchial lumen of children with protracted bacterial bronchitis[J]. Cureus, 2021, 13(12): e20554. |
| [15] | Gallucci M, Pedretti M, Giannetti A, et al. When the cough does not improve: a review on protracted bacterial bronchitis in children[J]. Front Pediatr, 2020, 8: 433. |
| [16] | Kantar A, Chang AB, Shields MD, et al. ERS statement on protracted bacterial bronchitis in children[J]. Eur Respir J, 2017, 50(2): 1602139. |
| [17] | 史军然, 刘金荣, 李惠民, 等. 持续性细菌性支气管炎31例诊治分析[J]. 中华儿科杂志, 2016, 54(7): 527-530. |
| [18] | 管栋, 王晓丽, 李海燕, 等. 青岛地区102例儿童迁延性细菌性支气管炎临床特征分析[J]. 中国小儿急救医学, 2021, 28(11): 968-971. |
| [19] | Zhang XB, Wu X, Nong GM. Update on protracted bacterial bronchitis in children[J]. Ital J Pediatr, 2020, 46(1): 38. |
| [20] | Verhulst S, Boel L, Van Hoorenbeeck K. Protracted bacterial bronchitis: bronchial aspirate versus bronchoalveolar lavage findings: a single-centre retrospective study[J]. BMJ Paediatr Open, 2019, 3(1): e000507. |
| [21] | Gross-Hodge E, Carroll WD, Rainford N, et al. Duration of initial antibiotic course is associated with recurrent relapse in protracted bacterial bronchitis[J]. Arch Dis Child, 2020, 105(11): 1111-1113. |
| [22] | Korppi M. Review shows paediatric protracted bacterial bronchitis needs an accurate diagnosis and strictly targeted extended antibiotics[J]. Acta Paediatr, 2019, 108(5): 823-827. |
| [23] | Wang Y, Hao C, Ji W, et al. Detecting respiratory viruses in children with protracted bacterial bronchitis[J]. Respir Med, 2019, 151: 55-58. |
| [24] | Kompare M, Weinberger M. Protracted bacterial bronchitis in young children: association with airway malacia[J]. J Pediatr, 2012, 160(1): 88-92. |
| [25] | Wang Y, Hao C, Chi F, et al. Clinical characteristics of protracted bacterial bronchitis in Chinese infants[J]. Sci Rep, 2015, 5: 13731. |
| [26] | Chang AB, Oppenheimer JJ, Irwin RS, et al. Managing chronic cough as a symptom in children and management algorithms: CHEST guideline and expert panel report[J]. Chest, 2020, 158(1): 303-329. |
| [27] | Shields MD, Bush A, Everard ML, et al. BTS guidelines: recommendations for the assessment and management of cough in children[J]. Thorax, 2008, 63 Suppl 3: iii1-iii15. |
| [28] | Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children[J]. Eur Respir J, 2020, 55(1): 1901136. |
| [29] | 中华医学会儿科学分会呼吸学组慢性咳嗽协作组,《中国实用儿科杂志》编辑委员会. 中国儿童慢性湿性咳嗽的诊断与治疗专家共识 (2019年版)[J]. 中国实用儿科杂志, 2019, 34(4): 256-264. |
| [30] | 中华医学会儿科学分会临床药理学组, 国家儿童健康与疾病临床医学研究中心, 中华医学会儿科学分会呼吸学组, 等. 中国儿童咳嗽诊断与治疗临床实践指南(2021版)[J]. 中华儿科杂志, 2021, 59(9): 720-729. |
| [31] | Gilchrist FJ, Carroll WD. Managing chronic wet cough in children: another piece of the puzzle[J]. Lancet Respir Med, 2021, 9(10): 1078-1079. |
| [32] | Wong OY, Marchant JM, Yerkovich ST, et al. Predictors of time to cough resolution in children with chronic wet cough treated with antibiotics after bronchoscopy[J]. Pediatr Pulmonol, 2019, 54(12): 1997-2002. |
| [33] | Armstrong D. Long-term follow-up of children with protracted bacterial bronchitis: some answers, and more questions[J]. Respirology, 2021, 26(3): 218-219. |
| [34] | Marchant J, Masters IB, Champion A, et al. Randomised controlled trial of amoxycillin clavulanate in children with chronic wet cough[J]. Thorax, 2012, 67(8): 689-693. |
| [35] | Ruffles TJC, Goyal V, Marchant JM, et al. Duration of amoxicillin-clavulanate for protracted bacterial bronchitis in children (DACS): a multi-centre, double blind, randomised controlled trial[J]. Lancet Respir Med, 2021, 9(10): 1121-1129. |
| [36] | 李莉, 李晶, 王文建. 儿童哮喘合并迁延性细菌性支气管炎3例临床分析[J]. 临床儿科杂志, 2019, 37(12): 953-956. |
| [37] | Chang AB, Oppenheimer JJ, Weinberger MM, et al. Management of children with chronic wet cough and protracted bacterial bronchitis: CHEST guideline and expert panel report[J]. Chest, 2017, 151(4): 884-890. |
| [38] | Gilchrist FJ. An approach to the child with a wet cough[J]. Paediatr Respir Rev, 2019, 31: 75-81. |
| [39] | 刘静月, 付文龙, 耿刚. 支气管镜在儿童迁延性细菌性支气管炎中的应用价值[J]. 重庆医科大学学报, 2022, 47(9): 1069-1073. |
| [40] | 李岚, 刘恩梅, 郝创利, 等. 儿童及迁延性细菌性支气管炎临床诊治的前瞻性多中心研究[J]. 江西医药, 2021, 56(2): 168-172. |
| [41] | 李银, 谢晓虹, 任洛, 等. 儿童迁延性细菌性支气管炎30例临床特征及随访分析[J]. 中华实用儿科临床杂志, 2017, 32(16): 1231-1234. |
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