Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.
Acta Paediatr. 2019 May;108(5):823-827. doi: 10.1111/apa.14705. Epub 2019 Jan 15.
In 2017, the European Respiratory Society task force stated that protracted bacterial bronchitis (PBB) was a distinct clinical entity and outlined the diagnostic criteria and principles for treatment. However, this guidance was based on data from Australia and the USA. This mini review evaluated the data and addressed the lack of research-based data from Europe.
We supplemented the 2017 report by conducting a nonsystematic review of the literature on prolonged wet or productive cough and on PBB in children up to September 2018.
Our review confirmed the lack of European data on PBB. Based on the available literature, and the 2017 European guidance, PBB is a wet or productive cough that lasts for four or more weeks, with no signs or symptoms, known as specific cough pointers, which suggest an underlying illness. PBB usually recovers with appropriate antibiotics for two weeks. Failing that radiological investigations or lung function measurements are needed. If PBB occurs three times over 12 months, then computerised tomography can diagnose bronchiectasis and determine other permanent changes.
More data are needed on PBB, especially in Europe. The implementation of PBB may help clinicians to prescribe antibiotics more effectively and reduce their inappropriate use.
2017 年，欧洲呼吸学会工作组指出，迁延性细菌性支气管炎（PBB）是一种独特的临床实体，并概述了诊断标准和治疗原则。然而，该指南是基于澳大利亚和美国的数据。本小型综述评估了相关数据，并针对缺乏来自欧洲的基于研究的数据的情况进行了讨论。
我们通过对截至 2018 年 9 月的关于迁延性湿咳或湿性咳嗽和儿童 PBB 的文献进行非系统性综述，对 2017 年报告进行了补充。
我们的综述证实了欧洲缺乏关于 PBB 的数据。基于现有文献和 2017 年欧洲指南，PBB 是一种持续 4 周或更长时间的湿或湿性咳嗽，没有任何迹象或症状，即特定的咳嗽指针，提示潜在疾病。通常，适当的抗生素治疗两周即可治愈 PBB。如果无效，则需要进行影像学检查或肺功能测量。如果 PBB 在 12 个月内发生 3 次，则可以通过计算机断层扫描诊断支气管扩张症，并确定其他永久性改变。
需要更多关于 PBB 的数据，尤其是在欧洲。PBB 的实施可以帮助临床医生更有效地开具抗生素，并减少其不合理使用。
