Controversies in Antibiotic Use for Chronic Wet Cough in Children

Cough is the most common complaint among primary healthcare visits in pediatrics. 1 Irwin R.S. Richardson N.D. Patient-focused care: using the right tools. Chest. 2006; 130: 73S-82S Abstract Full Text Full Text PDF PubMed Scopus (106) Google Scholar ,2 Goldsobel A.B. Chipps B.E. Cough in the pediatric population. J Pediatr. 2010; 156: 352-358 Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar Chronic cough in young children typically is defined as cough lasting 4 weeks. 3 Marchant J.M. Newcombe P.A. Juniper E.F. Sheffield J.K. Stathis S.L. Chang A.B. What is the burden of chronic cough for families?. Chest. 2008; 134: 303-309 Abstract Full Text Full Text PDF PubMed Scopus (163) Google Scholar ,4 Bailey E.J. Morris P.S. Kruske S.G. Chang A.B. Clinical pathways for chronic cough in children. Cochrane Database Syst Rev. 2008; : CD006595 PubMed Google Scholar Published guidelines for systematic evaluation of children with chronic cough differentiate dry and wet cough as part of the evaluation as they suggest distinct clinical entities. 5 Chang A.B. Oppenheimer J.J. Weinberger M.M. Rubin B.K. Grant C.C. Weir K. et al. Management of children with chronic wet cough and protracted bacterial bronchitis: CHEST guideline and expert panel report. Chest. 2017; 151: 884-890 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar ,6 Kantar A. Chang A.B. Shields M.D. Marchant J.M. Grimwood K. Grigg J. et al. ERS statement on protracted bacterial bronchitis in children. Eur Respir J. 2017; 501602139 Crossref PubMed Scopus (100) Google Scholar Wet cough suggests secretions in the airways. 7 Chang A.B. Gaffney J.T. Eastburn M.M. Faoagali J. Cox N.C. Masters I.B. Cough quality in children: a comparison of subjective vs. bronchoscopic findings. Respir Res. 2005; 6: 3 Crossref PubMed Scopus (118) Google Scholar Research varies on how good parents are at noting dry vs wet cough. 7 Chang A.B. Gaffney J.T. Eastburn M.M. Faoagali J. Cox N.C. Masters I.B. Cough quality in children: a comparison of subjective vs. bronchoscopic findings. Respir Res. 2005; 6: 3 Crossref PubMed Scopus (118) Google Scholar ,8 Donnelly D. Everard M.L. ‘Dry' and ‘wet' cough: how reliable is parental reporting?. BMJ Open Respir Res. 2019; 6e000375 Crossref Scopus (10) Google Scholar Guidelines recommend treating chronic wet cough of 4 weeks or longer with antibiotics. 5 Chang A.B. Oppenheimer J.J. Weinberger M.M. Rubin B.K. Grant C.C. Weir K. et al. Management of children with chronic wet cough and protracted bacterial bronchitis: CHEST guideline and expert panel report. Chest. 2017; 151: 884-890 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar ,9 Chang A.B. Oppenheimer J.J. Irwin R.S. Managing chronic cough as a symptom in children and management algorithms: CHEST guideline and expert panel report. Chest. 2020; 158: 303-329 Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar