Outcomes in children treated for persistent bacterial bronchitis
Outcomes in children treated for persistent bacterial bronchitis
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DOI：
10.1136/thx.2006.058933
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发表时间：
2007-01-01
期刊：
影响因子：
10
通讯作者：
Everard, Mark L.
中科院分区：
文献类型：
--
作者：
Donnelly, Deirdre;Critchlow, Anita;Everard, Mark L.
背景：持续性细菌性支气管炎(PBB)似乎没有得到足够的认识，常常被误诊为哮喘。在缺乏关于这一组患者的治疗和结果的公开数据的情况下，我们回顾了在儿科呼吸系统诊所就诊的PBB患者的结果。方法：对81例确诊为PBB的患者进行了回顾性图表回顾。诊断基于持续1个月的持续湿咳的标准，并通过适当的抗生素治疗缓解。结果：最常见的转诊原因是持续咳嗽或难治性哮喘。在大多数患者中，症状在2岁之前就开始了，59%的患者已经出现了一年。在转诊时，59%的患者正在接受哮喘治疗，11%的患者正在接受抗生素治疗。流感嗜血杆菌和肺炎链球菌是最常见的分离菌。超过一半的患者在两个疗程的抗生素治疗后完全没有症状。只有13%的患者需要6个疗程的抗生素。结论：PBB经常被误诊为哮喘，尽管这两种情况可能并存。除了消除持续的咳嗽，治疗还可以防止进展为支气管扩张。关于诊断和治疗的进一步研究是迫切需要的。
Background: Persistent bacterial bronchitis (PBB) seems to be under-recognised and often misdiagnosed as asthma. In the absence of published data relating to the management and outcomes in this patient group, a review of the outcomes of patients with PBB attending a paediatric respiratory clinic was undertaken.Methods: A retrospective chart review was undertaken of 81 patients in whom a diagnosis of PBB had been made. Diagnosis was based on the standard criterion of a persistent, wet cough for > 1 month that resolves with appropriate antibiotic treatment.Results: The most common reason for referral was a persistent cough or difficult asthma. In most of the patients, symptoms started before the age of 2 years, and had been present for > 1 year in 59% of patients. At referral, 59% of patients were receiving asthma treatment and 11% antibiotics. Haemophilus influenzae and Streptococcus pneumoniae were the most commonly isolated organisms. Over half of the patients were completely symptom free after two courses of antibiotics. Only 13% of patients required >= 6 courses of antibiotics.Conclusion: PBB is often misdiagnosed as asthma, although the two conditions may coexist. In addition to eliminating a persistent cough, treatment may also prevent progression to bronchiectasis. Further research relating to both diagnosis and treatment is urgently required.