CHEST Guidelines-Recurrence-of-Protracted-Bacterial-Bronchitis-in-C

Recurrence-of-Protracted-Bacterial-Bronchitis-in-C

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In a recent correspondence published in CHEST, the authors Sacco et al. discuss findings from an article by Wurzel et al., which examined the progression and risks of bronchiectasis in children with protracted bacterial bronchitis (PBB). Their study evaluated 161 children over two years, highlighting that 43.5% of these children experienced over three episodes of bacterial bronchitis annually, and 8.1% were diagnosed with bronchiectasis. A significant finding was the role of Haemophilus influenzae, which was present in 85% of children who developed bronchiectasis, suggesting a potential pathogenic role in chronic respiratory disorders due to its ability to form biofilms.<br /><br />The correspondence emphasizes the challenge in treating PBB due to the biofilm formation and antibiotic resistance resulting from Haemophilus influenzae, especially when exposed to subinhibitory concentrations of beta-lactam antibiotics. Such exposure may encourage biofilm development and antibiotic resistance, compounding the condition's recurrence and complicating treatment. The authors suggest adhering strictly to antibiotic regimens to avoid subinhibitory levels, proposing adjustments in dosage or frequency to maintain effective drug concentrations.<br /><br />The response from the original study authors, Wurzel et al., concurs with Sacco et al.'s points, acknowledging the recurrence rates in PBB cases often accompany Haemophilus influenzae presence. They stress the importance of monitoring and adjusting treatments to mitigate the risk of bacterial bronchitis progression to bronchiectasis.<br /><br />Both pieces highlight a critical need for vigilant treatment practices and potential alterations in current therapeutic approaches to better manage PBB in children and prevent long-term complications like bronchiectasis.

Keywords

bronchiectasis

protracted bacterial bronchitis

Haemophilus influenzae

biofilm formation

antibiotic resistance

beta-lactam antibiotics

pediatric respiratory disorders

treatment challenges

chronic bronchitis

therapeutic adjustments