Gilchrist, FJ, Aspey, M, Bowler, R, Brodlie, M, Desai, S, Harris, C, Hinton, E, Kulkarni, H, Ogbolosingha, A, Sinha, I, Solis-Trapala, I, Stock, J and Carroll, WD (2022) Protocol for CLASSIC PBB: comparison of lower airway sampling strategies in children with protracted bacterial bronchitis. BMJ Paediatrics Open, 6 (1). e001722 - e001722. ISSN 2399-9772

[thumbnail of e001722.full.pdf]
e001722.full.pdf - Published Version

Download (268kB) | Preview


Background Protracted bacterial bronchitis (PBB) is an endobronchial infection and a the most common cause of chronic wet cough in young children. It is treated with antibiotics, which can only be targeted if the causative organism is known. As most affected children do not expectorate sputum, lower airway samples can only be obtained by bronchoalveolar lavage (BAL) samples taken during flexible bronchoscopy (FB-BAL). This is invasive and is therefore reserved for children with severe or relapsing cases. Most children with PBB are treated empirically with broad spectrum antibiotics. CLASSIC PBB will compare the pathogen yield from two less invasive strategies with that from FB-BAL to see if they are comparable.

Methods 131 children with PBB from four UK centres referred FB-BAL will be recruited. When attending for FB-BAL, they will have a cough swab and an induced sputum sample obtained. The primary outcome will be the discordance of the pathogen yield from the cough swab and the induced sputum when compared with FB-BAL. Secondary outcomes will be the sensitivity of each sampling strategy, the success rate of the induced sputum in producing a usable sample and the tolerability of each of the three sampling strategies.

Discussion If either or both of the two less invasive airway sampling strategies are shown to be a useful alternative to FB-BAL, this will lead to more children with PBB having lower airway samples enabling targeted antibiotic prescribing. It would also reduce the need for FB, which is known to be burdensome for children and their families.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC705 Diseases of the respiratory system
R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 14 Dec 2022 09:16
Last Modified: 23 Feb 2023 09:57

Actions (login required)

View Item
View Item