Last updated March 14, 2022

Chronic Cough Related to Acute Viral Bronchiolitis in Children

Suggestions

1. For children with chronic cough (>4 weeks) after acute viral bronchiolitis, we suggest that the cough be managed according to the CHEST pediatric chronic cough guidelines. (U-CBS)
Remark: These include the evaluation for the presence of cough pointers and the use of 2 weeks of antibiotics targeted to common respiratory bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) and local antibiotic sensitivities managing in children with wet or productive cough unrelated to an underlying disease and without any specific cough pointers (eg, coughing with feeding, digital clubbing).
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2. For children with chronic cough (>4 weeks) after acute viral bronchiolitis, we suggest that asthma medications not be used for the cough unless other evidence of asthma is present. (U-CBS)
Remark: Symptoms of asthma include the presence of recurrent wheeze and/or dyspnea.
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3.. For children with chronic cough (>4 weeks) after acute viral bronchiolitis, we suggest that inhaled osmotic agents not be used. (U-CBS)
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Recommendation Grading

Overview

Title

Chronic Cough Related to Acute Viral Bronchiolitis in Children

Authoring Organization

Publication Month/Year

August 1, 2018

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

Acute bronchiolitis is common in young children, and some children develop chronic cough after their bronchiolitis. We thus undertook systematic reviews based on key questions (KQs) using the PICO (Population, Intervention, Comparison, Outcome) format. The KQs were: Among children with chronic cough (> 4 weeks) after acute viral bronchiolitis, how effective are the following interventions in improving the resolution of cough?: (1) Antibiotics. If so what type and for how long? (2) Asthma medications (inhaled steroids, beta2 agonist, montelukast); and (3) Inhaled osmotic agents like hypertonic saline?

Target Patient Population

Children with chronic cough after bronchiolitis

Inclusion Criteria

Female, Male, Child

Health Care Settings

Ambulatory, Childcare center, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management, Treatment

Diseases/Conditions (MeSH)

D001988 - Bronchiolitis, D010372 - Pediatrics, D003371 - Cough, D018927 - Anti-Asthmatic Agents

Keywords

pediatric, antibiotic, bronchiolitis, cough, chronic cough, pediatrics