Background

Protracted bacterial bronchitis (PBB) is the most common cause of chronic productive cough, especially in young children and little is known about long-term consequences.  

Aim

To analyse risk factors for PBB in infancy and long-term sequelae at school age.

Method

63 school-aged children (12.4 years) of originally 200 infants with PBB (3.2 years) were interviewed after 8.5 years (5.4-14.6) in a follow-up study to risk factors and previous as well as current complaints. All performed pulmonary function tests (PFTs: bodyplethysmography, multiple breath washout). Another 320 children served as control group. Lung function results were compared with international reference values.

Results

Retrospective analysis of infants with PBB showed a high prevalence of recurrent bronchitis at preschool age (86%), nicotine exposure (45%) and prematurity (25%). At follow-up, chronic productive cough was present in 17.5% of post-PBB children (9% in controls, p=0.05) and asthma in 48% (controls 10%, p<0.001). Post-PBB children were significantly more likely to have abnormal spirometry (24.2%, p=0.002). Risk factors for chronic productive cough at school age were repeated episodes of PBB (p=0.007), history of pneumonia (p=0.013) and nicotine exposure (p=0,009) at young age.

Conclusion

Our study confirms that a significant proportion of children with PBB develop long-term bronchopulmonary sequelae, measurable by abnormal PFTs. We found an association of PBB and later asthma. Retrospective analysis revealed, in addition to nicotine exposure, that prematurity is a risk factor for PBB. To avoid late bronchopulmonary sequelae, continuous follow-up of these children is necessary.