Protracted bacterial bronchitis is a lung condition marked by a lasting wet cough. It requires prompt antibiotic treatment to prevent serious complications.
Protracted bacterial bronchitis (PBB) is a lung condition that happens when you get a bacterial infection in your airways. It’s characterized by a persistent wet cough lasting more than 4 weeks.
PBB is typically diagnosed in young children and requires antibiotics to resolve the infection and manage symptoms effectively.
Causes of protracted bacterial bronchitis (PBB)
Protracted bacterial bronchitis is associated with ongoing bacterial infections in the airways, commonly caused by the following types of bacteria:
Contributing factors to developing PBB may also include:
- Defects in immune function: Weaknesses or abnormalities in the immune system can prevent it from effectively fighting off bacterial infections.
- Structural abnormalities in the airways: Physical abnormalities in the respiratory tract can create an environment where bacteria can thrive, leading to chronic infections.
- Bacterial biofilm formation: Bacteria can form protective clusters called biofilms on surfaces in the respiratory tract, making them more resistant to antibiotics and harder to remove.
- Impaired airway clearance: The respiratory system may have a reduced ability to clear mucus and pathogens from the airways, leading to ongoing infections.
Risk factors for protracted bacterial bronchitis
Research from 2021 notes that PBB is more common in people:
- under age 2 (with the highest risk under 12 months)
- who are male
- who attend day care
- with a history of chronic cough
Having asthma or reactive airway disease , as well as a history of bronchiolitis , reduces your risk of developing PBB.
How common is protracted bacterial bronchitis?
Research from 2018 suggests that protracted bacterial bronchitis is the second most common cause of chronic cough in children under 6 years old, with asthma being the most common.
Protracted bacterial bronchitis is found in about 40% of children with a chronic wet cough. About 9% of these children may also have bronchiectasis , a more severe condition in which the airways become damaged and widened.
Symptoms of protracted bacterial bronchitis (PBB)
The symptoms of PBB include:
- a persistent wet cough lasting more than 4 weeks
- a cough that may worsen at night or with activity
- possible wheezing or breathing difficulties
- excessive mucus production
- fatigue or irritability
- possible recurrent respiratory infections
Next steps for protracted bacterial bronchitis
If you suspect PBB, the immediate steps to take are:
- Consult a healthcare professional: Get a diagnosis from a doctor who can confirm PBB and rule out other conditions.
- Follow antibiotic treatment: To clear the bacterial infection, follow the prescribed course of antibiotics, typically amoxicillin-clavulanate. Always make sure to take the full course of antibiotics prescribed.
- Monitor symptoms: Track the cough and other symptoms to ensure you or your child is improving with treatment.
- Follow-up: Schedule follow-up appointments to ensure the infection is resolving and to check for any complications.
Treatment options for protracted bacterial bronchitis (PBB)
To treat PBB, doctors usually prescribe a course of antibiotics lasting 2 to 6 weeks. More than 60% of PBB cases resolve after this treatment.
The choice of antibiotics — such as amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, or cefdinir — will depend on the bacteria identified. This is done with a sputum culture.
Only a healthcare professional will be able to tell you which antibiotic should best treat the infection.
If symptoms persist despite several oral antibiotic treatments, hospitalization for bronchoscopy and IV antibiotics might be needed.
Airway clearance techniques, like chest physiotherapy and nebulizer treatments with hypertonic saline, can also help by loosening and thinning mucus to make coughing easier.
Will protracted bacterial bronchitis go away on its own?
Protracted bacterial bronchitis generally does not resolve on its own without treatment.
If it’s not treated with antibiotics, PBB can lead to persistent inflammation and damage in the airways, which might increase the risk of developing bronchiectasis .
Are protracted bacterial bronchitis treatments covered by insurance?
Treatment for protracted bacterial bronchitis is generally covered by insurance, as it involves medically necessary antibiotics. Coverage often includes the costs for the antibiotic prescription and associated medical consultations.
In the ICD-10, PBB is classified under “Chronic bronchitis due to bacteria” with the code J42 (Chronic bronchitis, unspecified).
Always check with your specific insurance provider for detailed coverage information and any potential out-of-pocket costs.
Takeaway
Protracted bacterial bronchitis is a lung condition that primarily affects young children. It’s characterized by a wet cough that lasts for more than 4 weeks.
Treatment involves antibiotics, which are crucial for clearing the infection and relieving symptoms. Early diagnosis and treatment are essential to prevent complications and ensure a full recovery.
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