CHEST Guidelines-Management-of-Children-With-Chronic-Wet-Cough-and- (1)

Management-of-Children-With-Chronic-Wet-Cough-and- (1)

Pdf Summary

The CHEST Guideline and Expert Panel Report, led by Anne B. Chang and others, addresses the management of chronic wet cough and protracted bacterial bronchitis (PBB) in children up to 14 years old. Chronic wet or productive cough is common in children and may not always indicate an underlying disease. The panel developed guidelines based on two key questions: the effectiveness of antibiotics in resolving chronic wet cough and when further investigations are needed.<br /><br />Key recommendations include prescribing a two-week course of antibiotics targeting common respiratory bacteria for children showing chronic wet cough without signs of an underlying disease. If the cough resolves with this treatment, a diagnosis of PBB should be made. If the cough persists, further investigations such as flexible bronchoscopy or chest CT scans should be considered, especially if specific indicators like digital clubbing or cough with feeding are present.<br /><br />The report highlights the necessity of differentiating between clinically-based PBB, diagnosed through treatment response, and microbiologically-based PBB, confirmed with lower airway bacteria density tests. It also calls for further clinical trials, particularly in primary care settings, to better understand optimal treatment durations and the need for investigations, especially in cases where the cough does not respond to antibiotics.<br /><br />The guideline update emphasizes the importance of appropriate early diagnosis and antibiotic treatment for chronic wet cough to potentially improve future lung health. However, it notes a lack of comprehensive data from primary healthcare settings and the need for more extensive studies to supplement current findings.

Keywords

chronic wet cough

protracted bacterial bronchitis

children

antibiotics

guidelines

diagnosis

treatment

primary care

lung health

clinical trials