CHEST Guidelines-Management-of-Children-With-Chronic-Wet-Cough-and-

Management-of-Children-With-Chronic-Wet-Cough-and-

Pdf Summary

The CHEST Guideline and Expert Panel Report addresses the management of chronic wet cough and protracted bacterial bronchitis (PBB) in children up to age 14. The document forms recommendations based on systematic reviews, focusing on two main questions: the effectiveness of antibiotics in treating chronic wet cough and criteria for further clinical investigations.<br /><br />The guidelines conclude that children with chronic wet cough of unknown cause should initially be treated with a 2-week course of antibiotics targeting common respiratory bacteria. If the cough resolves within this period, a diagnosis of PBB can be considered. If the cough persists, a further 2-week antibiotic course is recommended. Children showing no improvement after 4 weeks, or those presenting specific symptoms like digital clubbing, should undergo further investigations such as bronchoscopy or CT scans to rule out underlying diseases.<br /><br />The guidelines emphasize the need for more research, particularly in primary care settings, to evaluate the management of chronic wet cough and antibiotic duration. Current evidence supports antibiotic treatment for cough resolution, but there is variability in the type and duration required. <br /><br />Importantly, PBB, a clinical entity characterized by a chronic wet cough that resolves with antibiotics and possibly confirmed by respiratory bacteria in lower airways, is now recognized in the guidelines. However, there's limited high-quality evidence regarding the diagnosis and management outside of specialized centers, prompting calls for further research.<br /><br />In summary, the guidelines provide evidence-based recommendations for the initial treatment and further investigation of chronic wet cough in children while highlighting areas where more research is needed to improve management strategies.

Keywords

chronic wet cough

protracted bacterial bronchitis

children

antibiotics

clinical investigations

bronchoscopy

CT scans

primary care

respiratory bacteria

evidence-based recommendations