CLINICAL FEATURES OF THE COURSE AND ASSESSMENT OF TREATMENT STRATEGY IN CHILDREN WITH BRONCHITIS
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Keywords

children, Bronchitis Severity Score, bronchitis

How to Cite

Olena К. Koloskova, Tatiana М. Bilous, Galyna A. Bilyk, Roman V. Tkachuk, & Maryana V. Dikal. (2021). CLINICAL FEATURES OF THE COURSE AND ASSESSMENT OF TREATMENT STRATEGY IN CHILDREN WITH BRONCHITIS. Eastern Ukrainian Medical Journal, 9(2), 157-165. https://doi.org/10.21272/eumj.2021;9(2):157-165

Abstract

Introduction. Respiratory diseases always account for a significant proportion of visits to the pediatrician or family doctor, and bronchitis is usually a frequent clinical manifestation of acute respiratory diseases. The doctor often faces the question of how to objectively assess the clinical picture of bronchitis, and now the assessment of respiratory symptoms is often based on criteria such as cough, shortness of breath or wheezing on auscultation. However, today there are practically no data on the severity of bronchitis in children depending on the above criteria.

Materials and methods. A cohort of 158 children with bronchitis was created at the pulmonology and allergology Department of the Municipal Medical Institution "Regional Children's Clinical Hospital" in Chernivtsi. The severity of bronchitis was assessed at the beginning and on the 3rd and 7th day of inpatient using the Bronchitis Severity Score (BSS). According to this scale, mild bronchitis was verified in 30 patients which formed the I clinical group, and 128 children had moderate bronchitis (II clinical comparison group).

Discussion. Aggressive inflammation of the bronchi in children with moderate inflammation of the bronchial tree compared with patients with mild bronchitis was accompanied 1.6 times more often by recurrence, a history of episodes of community-acquired pneumonia in 9.4% of patients, long-term inpatient treatment (odds ratio 2.6) and halving the duration of the outpatient treatment period. The study of clinical severity of bronchitis in children of the comparison groups made it possible to establish an increase in the chances of a more severe course of the disease on the 7th day of hospitalization in children with moderate bronchitis (odds ratio 4.8) with persistence of cough in 68.7% of children in this group (odds ratio 3.8). Evaluation of inpatient treatment tactics indicated the need to increase the volume of complex therapy in patients with moderate bronchitis relative to children with mild disease (odds ratio 12.0, relative risk 8.8), as well as increasing the risk of the need for antibacterial therapy (odds ratio 3.7, relative risk 2.8) and the appointment of intravenous antibiotics for more than 3 days (odds ratio 5.0, relative risk 1.1).

https://doi.org/10.21272/eumj.2021;9(2):157-165
Article PDF (Українська)

References

1. Kinkade S., Long NA. Acute Bronchitis. Am Fam Physician. 2016;94(7):560-565.
2. Fleming DM, Elliot AJ. The management of acute bronchitis in children. Expert Opinion on Pharmacotherapy. 2007;8(4):415-426. https://doi.org/10.1517/14656566.8.4.415
3. Tackett KL, Atkins A. Evidence-based acute bronchitis therapy. J Pharm Pract. 2012;25:586-90. doi:10.1177/0897190012460826
4. Thompson M, Vodicka TA, Blair PS. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ. 2013;347:f7027. doi: 10.1136/bmj.f7027.
5. Lyu YR, Yang W-K, Park SJ, Kim S-H, Kang W-C, Jung IC, Park YC. Efficacy and safety of GHX02 in the treatment of acute bronchitis: protocol of a phase II, double-blind, randomised placebo-controlled trial. BMJ Open. 2018; 8(5): e019897. doi: 10.1136/bmjopen-2017-019897
6. Wurzel DF, Marchant JM, Yerkovich ST, Upham JW, Mackay IM, Masters IB, Chang AB. Prospective Characterization of Protracted Bacterial Bronchitis in Children. Chest. 2014;145(6):1271–1278. doi: 10.1378/chest.13-2442
7. Koehler U, Hildebrandt O, Fischer P, Gross V, Sohrabi K, Timmesfeld N, Saskia P, Urban C, Steiß J-O, Koelsch S, Kerzel S, Weissflog A. Time course of nocturnal cough and wheezing in children with acute bronchitis monitored by lung sound analysis. Eur J Pediatr. 2019;178(9):1385–1394. doi: 10.1007/s00431-019-03426-4
8. Albert RH. Diagnosis and treatment of acute bronchitis. Am Fam Physician 2010;82:1345–50.
9. Lehrl S, Kardos P, Matthys H, Kamin W. Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children – The BSS-ped. Open Respir Med J. 2018;12:50–66. doi: 10.2174/1874306401812010050
10. Matthys H, Kamin W. Positioning of the Bronchitis Severity Score (BSS) for standardised use in clinical studies. Curr Med Res Opin. 2013;29(10):1383-90. doi: 10.1185/03007995.2013.832183.
11. Moawad EMI, Haron MAE, Maher RMA, Abdallah EAA, Hussein H, Badawy NM, El-Rheem MEA. Cross-sectional evaluation of the Bronchitis Severity Score in Egyptian children: A move to reduce antibiotics. S Afr Med J. 2017;107(4):342-345. doi: 10.7196/SAMJ.2017.v107i4.11428.
12. Kardos P, Lehrl S, Kamin W, Matthys H. Assessment of the effect of pharmacotherapy in common cold/acute bronchitis - the Bronchitis Severity Scale (BSS). Pneumologie. 2014;68(8):542-6. doi: 10.1055/s-0034-1377332.
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