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Duration of initial antibiotic course is associated with recurrent relapse in protracted bacterial bronchitis
  1. Ellen Gross-Hodge1,
  2. Will D Carroll2,
  3. Naomi Rainford3,
  4. Carrol Gamble3,
  5. Francis J Gilchrist1,4
  1. 1Institute of Applied Clinical Science, Keele University, Keele, UK
  2. 2University Hospitals of North Midlands NHS Trust, Staffordshire, UK
  3. 3Liverpool Clinical Trials Centre, Liverpool, UK
  4. 4Paediatric Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
  1. Correspondence to Dr Francis J Gilchrist, Institute of Applied Clinical Science, Keele University, Keele ST5 5BG, UK; francis.gilchrist{at}


Protracted bacterial bronchitis (PBB) is the leading cause of chronic wet cough in young children from developed countries. Despite its high prevalence there is a paucity of evidence to inform the optimal duration of treatment leading to variation in practice. Relapse of chronic cough is common and recurrent PBB (>3 episodes in 12 months) is associated with a future diagnosis of bronchiectasis. We investigated the factors associated with any relapse (≥1 episode in 12 months) and recurrent PBB in 66 children. No factor was significantly associated with any relapse. Duration of initial antibiotic treatment was the only factor significantly associated with recurrent PBB. Those who received antibiotics for 6 weeks antibiotics were less likely to develop recurrent PBB than those who received for 2 weeks (p=0.046). This is the first study to show an association between duration of initial antibiotic course and therefore future bronchiectasis. Prospective studies are needed to investigate this association.

  • bacterial infection
  • bronchiectasis
  • cough
  • paediatric lung disease
  • respiratory infection
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  • Contributors EG-H collected the data, reviewed the drafts and approved the final version. WDC analysed the data, reviewed the drafts and approved the final version. NR undertook the statistical analysis and approved the final version. CG supervised the statistical analysis, reviewed the drafts and approved the final version. FJG conceptualised and designed the study, wrote the first draft, edited the drafts and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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