CHEST Guidelines-Chronic-Cough-Related-to-Acute-Viral-Bronchiolitis

Chronic-Cough-Related-to-Acute-Viral-Bronchiolitis

Pdf Summary

This CHEST Expert Panel Report addresses the issue of chronic cough in children following acute viral bronchiolitis. Acute bronchiolitis is a prevalent condition in young children, leading, in some cases, to prolonged coughing beyond the typical recovery period. Despite investigating interventions such as antibiotics, asthma medications, and inhaled osmotic agents, the panel found insufficient data to make specific recommendations on managing chronic cough post-bronchiolitis.<br /><br />Chronic cough is defined as persisting for more than four weeks following bronchiolitis. While 90% of children recover from bronchiolitis-related cough by day 21, those with symptoms persisting beyond this period may experience a distinct clinical issue, referred to as post-bronchiolitis syndrome. The panel's systematic reviews, formatted using the PICO method, concluded that existing data were not sufficient to support any clear intervention strategies for chronic cough.<br /><br />The panel offers consensus-based suggestions in the absence of robust evidence. They suggest managing chronic cough post-bronchiolitis according to the CHEST pediatric chronic cough guidelines, which involve evaluating specific symptoms and potentially employing a two-week course of antibiotics targeting common respiratory bacteria. Asthma medications and inhaled osmotic agents are not recommended for managing chronic cough unless there is additional evidence of asthma.<br /><br />To advance knowledge, the panel emphasizes the need for further research into the transition from acute to chronic cough and potential risk factors for developing chronic symptoms after bronchiolitis. They advocate for multi-center cohort studies and randomized controlled trials to explore effective interventions. This work has been endorsed by notable organizations such as the American College of Allergy, Asthma and Immunology, and the American Thoracic Society, highlighting its clinical importance.

Keywords

chronic cough

acute bronchiolitis

children

post-bronchiolitis syndrome

antibiotics

asthma medications

inhaled osmotic agents

PICO method

CHEST guidelines

multi-center studies