Re: Clarifying the diagnosis of PBB

Francis J Gilchrist, Dr,

Other Contributors:

October 07, 2014

Authors: Francis J Gilchrist1,2 ,Mark G Pritchard1, Warren Lenney1,2.

1. Academic Department of Child Health, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent ST4 6QG, United Kingdom

2. Institute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Thornburrow Road, Stoke-on-Trent ST4 7QB, United Kingdom

Correspondence Dr Francis J Gilchrist, Academic Department of Child Health, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent ST4 6QG, United Kingdom. Tel: 01782 675289 Email: francis.gilchrist@uhns.nhs.uk

We thank Professors Chang and Grimwood for their response to our letter. Only 10 years ago, protracted bacterial bronchitis (PBB) was not considered an entity by many of our Paediatric Respiratory colleagues. Although most now recognise PBB as a cause of wet cough in children, there is variation in the diagnostic criteria and treatment regimens used across the world. We wholeheartedly agree that there is an urgent need for prospective longitudinal studies to inform clinical practice.

In response to their specific comments. Of the ten children that did not fully respond to the initial course of antibiotics; three subsequently had complete resolution of their cough after further antibiotic courses. Suppurative lung disease was considered in the remaining seven and when clinically indicated a CT scan was undertaken. All of these were reported as normal. With regards to the use of prophylactic antibiotics; these were only started in children who had multiple relapses, especially when these relapses occurred very quickly after stopping treatment. Anecdotally these children have done very well but we refer again to the need for prospective studies to investigate the best treatment regimen.

Conflict of Interest:

None declared

Conflict of Interest

None declared