TY - JOUR T1 - Protracted bacterial bronchitis and malacias: Which came first , the chicken or the egg? JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 4654 AU - Marcela Moreno AU - Silvia Castillo AU - Carolina Castaño AU - Marta Trujillo AU - Nora Sivó AU - Amparo Escribano Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/4654.abstract N2 - Aims: to determine the prevalence of airway malacias in children diagnosed with persistent bacterial bronchitis (PBB) and evaluate the influence of malacias on the development of PBB.Methods: review of all children diagnosed with PBB in the last 8 years [wet chronic cough, atelectasis, noisy breathing, >104 colony forming units per millilitre of bacteria in bronchoalveolar lavage (BAL)], and all children diagnosed with tracheo or/and bronchomalacia. We investigated, in the PBB group, the association with malacias and in the malacia group, those with PBB. Major diagnostic (cystic fibrosis, primary ciliary, dyskinesia and immunodeficiency) were excluded.Results: 142 children with malacias, 121/142 tracheomalacias (56 moderate, 20 severe), 57/142 bronchomalacias and 36/142 tracheobronchomalacias. 53 children with PBB of which 40 had malacias (mainly moderate tracheomalacia) and only 10/53 BBP, have not malacias. 71% patients with malacias no had PBB at the moment of BAL. Average age of diagnosis of PBB was 3 years. The main indication for bronchoscopy was persistent cough. Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae were the most prevalent microorganisms. 24/53 PBB had neutrophilia in BAL. Most PBB were treated with amoxicillin clavulanate during 15-21 days, 72% responded favorably. 80% of those with unfavorable evolution had moderate to severe tracheomalacia.Conclusion: Patients PBB had high association with malacias, mainly moderate traqueomalacias, placing these functional abnormalities as a risk factor for persistent bronchial infection. This justify the empirical use of prolonged antibiotic treatment in patients with malacia and persistent bronchial symptoms. ER -