Untreated bacterial bronchitis in children may cause lasting lung damage, prompting calls for early detection and care tools.
A wet cough lasting more than four weeks is often dismissed as common in children and not a cause for concern. However, Dr. Anne Schlegtendal, a senior physician at the Universitätskinderklinik Bochum in Germany, disagrees.
She emphasizes that young children with protracted bacterial bronchitis (PBB) must be treated properly. “If they do not receive antibiotics for at least two weeks, there could be long-term pulmonary sequelae. In the worst case, they could develop irreversible, chronic lung damage.”
This conclusion comes from a study conducted by her team in Bochum, which examined children who had been hospitalized for PBB during early childhood. The findings were published in the journal Pediatric Pulmonology.
Noticeable pulmonary infection years later
“We identified 200 children who had developed PBB in early childhood and invited 63 of them to be re-examined and have their lung function tested at the Kinderklinik five to 14 years after their diagnosis,” says Anne Schlegtendal. “Among them were children who still have a chronic cough.”
It was revealed that not only are the children who were not properly treated affected, but that children who had received antibiotics were also at risk of developing long-term damage.
“Many of the children who had PBB in early childhood exhibit noticeable pulmonary function later on,” warns the pediatric pulmonologist. “Unfortunately, PBB is underdiagnosed and there is not yet a guideline in Germany for how to treat it, nor any recommendation that children suffering from it should undergo regular follow-up examinations.”
The researchers hope to change this. “We want to raise awareness of this disease to improve health in childhood and adolescence.”
The team thus used their idea for a digital decision support tool in pediatric outpatient clinics to apply to the innovation fund of the Federal Joint Committee to improve care for patients in the statutory health insurance system.
“Our idea is to use a digital signal system to identify and treat children with chronic cough and risk factors for eventual consequences earlier,” explains Schlegtendal. “Red would mean, go to the hospital right away.”
Reference: “Long-Term Pulmonary Sequelae 5–14 Years After Protracted Bacterial Bronchitis in Early Childhood” by Jan Hermann, Karen Brückner, Cordula Koerner-Rettberg, Stefanie Dillenhöfer, Folke Brinkmann, Christoph Maier, Christoph M. Heyer and Anne Schlegtendal, 5 May 2025, Pediatric Pulmonology.
DOI: 10.1002/ppul.71111
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