Chronic cough in children

Shields, Michael; Doherty, Gary M.

doi:10.1016/j.prrv.2012.05.002

Cited by 35 publications

(39 citation statements)

References 24 publications

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“…Bronchitis and chronic bronchitic symptoms are common and have been associated with substantial clinical morbidity and economic cost (14,(24)(25)(26). Bronchitis or questionnaire-based report of persistent cough and phlegm are relatively imprecise outcomes and likely represent a heterogeneous complex of conditions, including chronic, indolent respiratory illness, asthma exacerbation, or chronic airway inflammation.…”

Section: Discussionmentioning

confidence: 99%

Electronic Cigarette Use and Respiratory Symptoms in Adolescents

McConnell

Barrington‐Trimis

Wang

et al. 2017

Am J Respir Crit Care Med

328

227

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Rationale: Rates of adolescent electronic (e-) cigarette use are increasing, but there has been little study of the chronic effects of use.Components of e-cigarette aerosol have known pulmonary toxicity.Objectives: To investigate the associations of e-cigarette use with chronic bronchitis symptoms and wheeze in an adolescent population.Methods: Associations of self-reported use of e-cigarettes with chronic bronchitic symptoms (chronic cough, phlegm, or bronchitis) and of wheeze in the previous 12 months were examined in 2,086 Southern California Children's Health Study participants completing questionnaires in 11th and 12th grade in 2014.Measurements and Main Results: Ever e-cigarette use was reported by 502 (24.0%), of whom 201 (9.6%) used e-cigarettes during the last 30 days (current users). Risk of bronchitic symptoms was increased by almost twofold among past users (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.37-2.49), compared with never-users, and by 2.02-fold (95% CI, 1.42-2.88) among current users. Risk increased with frequency of current use (OR, 1.66; 95% CI, 1.02-2.68) for 1-2 days and 2.52 (95% CI, 1.56-4.08) for 3 or more days in past 30 days compared with never-users. Associations were attenuated by adjustment for lifetime number of cigarettes smoked and secondhand smoke exposure. However, risk of bronchitic symptoms among past e-cigarette users remained elevated after adjustment for relevant potential confounders and was also observed among never-cigarette users (OR, 1.70; 95% CI, 1.11-2.59). There were no statistically significant associations of e-cigarette use with wheeze after adjustment for cigarette use.Conclusions: Adolescent e-cigarette users had increased rates of chronic bronchitic symptoms. Further investigation is needed to determine the long-term effects of e-cigarettes on respiratory health.

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Section: Discussionmentioning

confidence: 99%

Electronic Cigarette Use and Respiratory Symptoms in Adolescents

McConnell

Barrington‐Trimis

Wang

et al. 2017

Am J Respir Crit Care Med

328

227

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“…2,3 The burden of cough is also reflected in the billions of dollars spent annually on over-the-counter cough medications. 2,4,5 An increasing number of algorithms and guidelines have been developed for the evaluation and diagnosis of chronic cough in children. 1,[6][7][8][9] Definition of Protracted Bacterial Bronchitis PBB is a chronic, persistent bacterial infection of conducting airways that has been increasingly recognized as an important pediatric condition worldwide.…”

Section: Protracted Bacterial Bronchitis: Promentioning

confidence: 99%

Pro-Con Debate: Protracted Bacterial Bronchitis as a Cause of Chronic Cough in Children

Bidiwala¹,

Krilov²,

Pirzada³

et al. 2015

Pediatr Ann

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Pro: Children with chronic cough present a diagnostic challenge. Protracted bacterial bronchitis (PBB) is a chronic, persistent bacterial infection of conducting airways defined by the presence of cough for longer than 4 weeks that resolves with antimicrobial therapy and without an alternative diagnosis. The diagnosis is made by the findings of increased bronchial secretions and edema of the lower airways on flexible bronchoscopy and positive cultures on bronchoalveolar lavage. It is speculated that an initial respiratory insult such as viral infection disrupts normal surface morphology and ciliary function, which leads to chronic self-perpetuating inflammation with the formation of bacterial biofilms, leading to PBB. PBB is often misdiagnosed as asthma, leading to inappropriate and excessive use of steroids. The importance of timely diagnosis should be emphasized due to the potential that PBB may be a precursor to chronic suppurative lung disease or bronchiectasis if left untreated; however, every patient should be adequately assessed to exclude other causes of chronic cough.Con: Clinical criteria for the diagnosis of PBB are nonspecific and may not distinguish it from other known causes of chronic cough, including viral infections. Benefits from antibiotic therapy (particularly prolonged therapy) have not been demonstrated. Respiratory conditions are the most common reason for antibiotic prescriptions during ambulatory visits in the United States, and many of these prescriptions are inappropriate and/or unnecessary. The proposed diagnostic criteria and recommendations for the treatment of PBB will lead to unnecessary overuse of antibiotics.

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“…In our multidisciplinary clinic, most of the patients with chronic cough have been seen by at least 1 specialist, and have failed a treatment trial before being seen (6). Cough can be seen as being caused by inflammation, increased secretions, or extra-respiratory causes (9). In general, chronic cough symptoms may be considered to be from one or a combination of any of the following (Table 1): upper airway; lower airway; GI tract, or other organ systems (cardiac, immune, or rheumatologic conditions) (8, 11, 12).…”

Section: Pediatric Pulmonologist Perspectivementioning

confidence: 99%

Aerodigestive Approach to Chronic Cough in Children

Naime

Batra

Fiorillo

et al. 2018

Curr Treat Options Peds

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Purpose of review: Chronic cough is the most common presenting complaint in a pediatric aerodigestive clinic. The etiology of chronic cough is varied and often includes more than one organ system. This review aims to summarize the current literature for a multidisciplinary approach when evaluating a child with chronic cough. Recent findings: There is very little medical literature focused on a multidisciplinary approach to chronic cough. In the limited data available, multidisciplinary clinics have been shown to be more cost-efficient for the families of children with complex medical problems, and also increase the likelihood of successfully obtaining a diagnosis. Summary: There is no consensus in the literature on how to work-up a child with chronic cough presenting to an aerodigestive clinic. Current studies from these clinics have shown improved outcomes related to cost-effectiveness and identifying definitive diagnoses. Future studies evaluating clinical outcomes are necessary to help delineate the utility of testing routinely performed, and to demonstrate the impact of interventions from each specialty on quality of life and specific functional outcome measures.

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Chronic cough in children

Cited by 35 publications

References 24 publications

Electronic Cigarette Use and Respiratory Symptoms in Adolescents

Electronic Cigarette Use and Respiratory Symptoms in Adolescents

Pro-Con Debate: Protracted Bacterial Bronchitis as a Cause of Chronic Cough in Children

Aerodigestive Approach to Chronic Cough in Children

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