Chronic cough-suppurative airway diseases in children

Chronic wet cough is in most cases an expression of chronic suppurative airway diseases, such as protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis. The PBB is defined as a chronic (several weeks) bronchial infection and inflammation caused by bacteria, the presence of isolated chronic wet cough and the absence of indicators suggestive of other specific chronic airway diseases. Primarily, it is diagnosed clinically (PBB clinical) and the cough resolves only after a prolonged course of appropriate antibiotics. Almost half of the affected children need several courses of antibiotics and many suffer a relapse. In these children, further investigations such as imaging, lung function testing, bronchoscopy, bronchoalveolar lavage and exclusion of alternative conditions are warranted. The most common pathogens found in bronchial secretions of children with PBB are Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumonia. Additional treatment options, which have not yet been sufficiently investigated for these indications are daily inhalation of hyperosmolar solutions and various forms of chest physiotherapy.