Four Weeks of Antibiotics better than 2 weeks course in Kids with Chronic Wet Cough
Protracted bacterial bronchitis (PBB) is a leading cause of chronic wet cough in children. In a recent study, researchers have found that four weeks of amoxicillin-clavulanate is better than 2 weeks regimen in treating chronic wet cough in children. The study findings were published in THE LANCET Respiratory Medicine on May 25, 2021.
The current standard treatment in European and American guidelines is 2 weeks of antibiotics, but the optimal duration of therapy is unknown. Therefore, Dr Tom J C Ruffles and his team conducted a first randomized controlled trial to assess the duration of antibiotic treatment in children with chronic wet cough and suspected PBB. The researchers hypothesized that 4 weeks of amoxicillin-clavulanate is superior to 2 weeks for improving clinical outcomes.
It was a multicenter, parallel, double-blind, placebo-controlled, randomized controlled trial. The researchers included a total of 106 children with chronic (>4 weeks duration) wet cough and suspected PBB. They were randomly assigned to receive 4 weeks of amoxicillin-clavulanate (25–35 mg/kg twice daily oral suspension; 4-week group n=52) or 2 weeks of amoxicillin-clavulanate followed by 2 weeks of placebo (2-week group n=54). The major outcome assessed was a clinical cure (cough resolution) by day 28. The researchers also assessed the recurrence of PBB at 6 months, time to next exacerbation, change in Parent-proxy Cough-Specific Quality-of-Life (PC-QoL) score from baseline to day 28 and from day 28 to 7 months, adverse events, nasal swab bacteriology, and antimicrobial resistance.
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