dc.contributor.author | Goyal, V | |
dc.contributor.author | Marchant, J | |
dc.contributor.author | Grimwood, K | |
dc.contributor.author | Masters, B | |
dc.contributor.author | Yerkovich, S | |
dc.contributor.author | Chang, A | |
dc.date.accessioned | 2021-05-24T03:47:28Z | |
dc.date.available | 2021-05-24T03:47:28Z | |
dc.date.issued | 2021 | |
dc.identifier.issn | 1323-7799 | |
dc.identifier.uri | http://hdl.handle.net/10072/404616 | |
dc.description.abstract | Introduction/Aim: Respiratory exacerbations in children with bronchiectasis are treated with antibiotics. While oral antibiotics are superior to placebo and recommended by guidelines to treat children with non-severe (non-hospitalized) exacerbations, not all will benefit. Therefore, we aimed to identify factors predicting those who will improve after a 14-day oral antibiotic course.
Methods: Demographic and clinical data from our two recently completed double-blind, double-dummy, randomized controlled trials were retrieved for the 202 children who received at least 14-days of oral antibiotics to treat their non-severe exacerbations. Univariable and multivariable logistic regression was used to identify factors associated with their response to antibiotics.
Results: Of the 202 children (51% males), 41% were Indigenous (Maori or Australian First Nations). Their median age was 4.2 (interquartile range 2.3–6.7) years at diagnosis of bronchiectasis. All received 14-days of amoxicillin-clavulanate or azithromycin. By Day-14, 130 (64%) children had improved according to validated cough score and clinical assessments, while 72 had not. Baseline characteristics were similar in both responder and non-responder groups. Univariable analysis found significant differences between groups for Indigenous ethnicity, number of non-hospitalized exacerbations needing antibiotics in the preceding 2-years, and number of lobes affected by bronchiectasis. Following multivariable analysis, Indigenous ethnicity (ORadjusted=4.70 95%CI 2.20–10.01), cough score at the exacerbation beginning (ORadjusted=0.58 95%CI 0.39–0.86) and number of lobes affected by bronchiectasis (ORadjusted=0.75 95%CI 0.57–0.99) were significant factors in identifying responders. Detecting a respiratory virus at the beginning of an exacerbation did not affect the response to antibiotics.
Conclusion: Among children with a non-severe bronchiectasis exacerbation, those more likely to respond to oral antibiotics were of Indigenous background, had less severe bronchiectasis as judged by a fewer number of affected lobes, and had less severe cough scores at the beginning of an exacerbation than those lacking these factors. | |
dc.language | English | |
dc.publisher | WILEY | |
dc.publisher.uri | https://onlinelibrary.wiley.com/doi/10.1111/resp.14021 | |
dc.relation.ispartofconferencename | TSANZSRS 2021 | |
dc.relation.ispartofconferencetitle | Respirology | |
dc.relation.ispartofdatefrom | 2021-05-01 | |
dc.relation.ispartofdateto | 2021-05-02 | |
dc.relation.ispartoflocation | Virtual | |
dc.relation.ispartofpagefrom | 79 | |
dc.relation.ispartofpageto | 79 | |
dc.relation.ispartofissue | S2 | |
dc.relation.ispartofvolume | 26 | |
dc.subject.fieldofresearch | Biomedical and clinical sciences | |
dc.subject.fieldofresearchcode | 32 | |
dc.subject.keywords | Science & Technology | |
dc.subject.keywords | Life Sciences & Biomedicine | |
dc.subject.keywords | Respiratory System | |
dc.title | Bronchiectasis exacerbations in children: What predicts the response to antibiotics? | |
dc.type | Conference output | |
dc.type.description | E3 - Conferences (Extract Paper) | |
dcterms.bibliographicCitation | Goyal, V; Marchant, J; Grimwood, K; Masters, B; Yerkovich, S; Chang, A, Bronchiectasis exacerbations in children: What predicts the response to antibiotics?, Respirology, 2021, 26, pp. 79-79 | |
dc.date.updated | 2021-05-21T06:49:18Z | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Grimwood, Keith | |