How much protracted is protracted bacterial bronchitis (PBB)

Introduction PBB is defined as chronic wet cough that responds to antibiotics, in the absence of any alternative diagnoses. We aimed to explore the clinical course of the disease after therapeutic interventions. Methods 71 children (M/F 36/35) with PBB, during the 2011-2014 period were studied. Children with CF, humoral immunodeficiency and PCD were excluded; not children with dysphagia/silent aspiration, since, we believe, this disorder could be a cause, not an alternative diagnosis. Proper prolonged/repeated courses of antibiotics and chest physiotherapy were implemented. Children free of cough for ≥12mo were considered as cured. Multivariate analysis was applied based on a Cox proportional hazards model, where duration of symptoms before diagnosis, age at diagnosis, sex, and premature birth, were used as predictors. Results The mean (sd) ages of symptoms presentation, and first referred to our clinic, were 38.5 (29.1) and 57.1 (30.7) mo, respectively. The mean delay in diagnosis was 18.5 (15.9) mo. 17 children (24.3%) were born prematurely (≤36w). 7 (9.8%) were with silent aspiration, 5 (7.0%) of whom suffered from minor neurodevelopmental disorders. 40 (56.3%) children were finally symptom free for ≥ 12mo, after treatment of varying duration (20.2 (7.7) mo). Multivariate analysis showed that prematurity was a statistically significant predictor (hazard ratio: 0.31, CI: 0.10-090, p=0.035). The above result roughly corresponds to a decrease in the probability of treatment by about 70% in case of a prematurely born child. Conclusion ln most cases, PBB represents a curable disease on the presumption that an intense and prolonged therapeutic approach is implemented. Prematurely born children have a worse prognosis.