Cough is one of the most common symptoms in those seeking primary healthcare and chronic cough (>4 weeks) causes considerate morbidity and reduced quality of life. Substantial work conducted by the team has defined the diagnostic entity known as protracted bacterial bronchitis (PBB). Numerous international studies in children with chronic wet cough have found PBB to be the most common cause, and PBB has now been incorporated into international cough guidelines. Appropriate management of children with chronic wet cough is important to ensure the condition is managed early and to prevent possible long-term poor lung outcomes. While antibiotic treatment is fundamental to PBB treatment, it is unclear what duration of antibiotic treatment should be used.

Aim

The aim of this study is to determine if a longer 4 week course of amoxycillin-clavulanic acid, compared to a shorter 2 week course, improves clinical outcomes.

Secondary aims are:

• To determine if there is a difference in the level of antibiotic resistance between the long and short-term antibiotic group
• To determine if a gene expression signature exists in those children who require 4 weeks of treatment

This study is funded by the Children’s Hospital Foundation and being conducted in Darwin and Brisbane.