RT Journal Article SR Electronic T1 Respiratory exacerbations in post infectious obliterative bronchiolitis JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA1014 DO 10.1183/13993003.congress-2019.PA1014 VO 54 IS suppl 63 A1 Chu-Hai Wong A1 William Daw A1 Kelechi Ugonna A1 Sonal Kansra YR 2019 UL http://erj.ersjournals.com/content/54/suppl_63/PA1014.abstract AB Post infectious obliterative bronchiolitis (PIBO) is an unusual and rare complication of lower respiratory tract infections in children, with Adenovirus being the most common cause. The condition is non progressive and treatments mostly supportive. Little is known about the respiratory morbidity from frequent exacerbations of respiratory symptoms.Methods: We describe the frequency and symptoms during exacerbation in a cohort of 12 patients for a mean 2.6 years after diagnosis. Diagnosis of PIBO was based on CT findings together with a suggestive clinical course. The exacerbations were classified as wheezy or infective based on the predominant symptom. Data on the types of symptoms and treatments given were collected.Results: Median age at diagnosis was 2 yrs 4 months. Most cases were post infective (80%) and the most common aetiologic agents were Adenovirus (60%), Rhinovirus (40%) and RSV (30%). Most patients were managed on long term anti-inflammatory therapy with Azithromycin and inhaled steroids. 5 patients were on home oxygen. The mean time between outpatient follow-up was 3 months. There was significant variability in the number of exacerbations ranging between 0 to 4 per year. Most children had infective exacerbations which did not usually lead to hospitalisation. Most were treated with oral antibiotics usually Co-amoxiclav. In the same individual the exacerbations are usually of the same types.Conclusion: There is considerable heterogeneity in the presentation of children with exacerbations. These may correlate with the extent of bronchiectasis radiologically. Outcomes could be improved by proactive antibiotic treatment if such a correlation can be studied in a larger cohort using a national database.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1014.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).