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Does failed chronic wet cough response to antibiotics predict bronchiectasis?

Goyal, Vikas, Grimwood, Keith, Marchant, Julie, Masters, Ian B. and Chang, Anne B. (2014). Does failed chronic wet cough response to antibiotics predict bronchiectasis?. Archives of Disease in Childhood,99(6):522-525.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 4
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IRMA ID cmartelxPUB97
Title Does failed chronic wet cough response to antibiotics predict bronchiectasis?
Author Goyal, Vikas
Grimwood, Keith
Marchant, Julie
Masters, Ian B.
Chang, Anne B.
Journal Name Archives of Disease in Childhood
Publication Date 2014
Volume Number 99
Issue Number 6
ISSN 1468-2044   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84901243737
Start Page 522
End Page 525
Total Pages 4
Place of Publication United Kingdom
Publisher B M J Group
HERDC Category C1 - Journal Article (DIISR)
Abstract Aim
To determine whether a child with chronic wet cough and poor response to at least 4 weeks of oral antibiotics is more likely to have bronchiectasis.

Methods
All chest multi-detector computerised tomography (MDCT) scans at a single paediatric tertiary hospital from April 2010 to August 2012 were reviewed retrospectively so as to identify those ordered by respiratory physicians for assessment of children with a chronic wet cough. Information regarding age, sex, ethnicity, indication for imaging and the response to at least 4 weeks of antibiotics before having the scan were recorded from their charts. The data were analysed using simple and multiple logistic regression.

Results

Of the 144 (87 males) eligible children, 106 (65 males, 30 Indigenous) aged 10–199 months had MDCT scan evidence of bronchiectasis. Antibiotic data were available for 129 children. Among the 105 children with persistent cough despite at least 4 weeks of antibiotics, 88 (83.8%) had bronchiectasis, while of the 24 children whose cough resolved after antibiotics, only six (25.0%) received this diagnosis (adjusted OR 20.9; 95% CI 5.36 to 81.8). Being Indigenous was also independently associated with radiographic evidence of bronchiectasis (adjusted OR 5.86; 95% CI 1.20 to 28.5).

Conclusions
Further investigations including a MDCT scan should be considered in a child with a chronic wet cough that persists following 4 weeks of oral antibiotics. However, while reducing the likelihood of underlying bronchiectasis, responding well to a single prolonged course of antibiotics does not exclude this diagnosis completely.

DOI http://dx.doi.org/10.1136/archdischild-2013-304793   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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