Fifteen-minute consultation: Diagnosing and managing protracted bacterial bronchitis in children and young people

Protracted bacterial bronchitis (PBB) is a frequent yet often underdiagnosed cause of chronic wet cough in young children, commonly mistaken for asthma or other respiratory conditions. It is characterised by a cough lasting more than 4 weeks that typically improves with an extended 4-6 week course of appropriate antibiotics, guided by allergy status and microbiological culture results where available, with co-amoxiclav being the usual first choice. PBB can progress to bronchiectasis if left untreated, with significant long-term implications for lung health. Early recognition is therefore crucial. This article outlines a practical approach to diagnosing PBB, emphasising the need to exclude other causes of persistent cough, obtain appropriate imaging and microbiological samples and consider specialist referral for non-responders to prolonged antibiotics or in recurrent cases. By promptly identifying and treating PBB, clinicians can reduce the risk of disease progression and improve long-term outcomes for paediatric patients.