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Protracted Bacterial Bronchitis — RACP Paediatrics MCQ

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ModerateRespiratoryProtracted Bacterial BronchitisRACP Paediatrics

A 2-year-old boy presents with a 4-week history of daily wet cough without wheeze. He has no history of recurrent pneumonia or failure to thrive. Chest X-ray is normal. What is the most appropriate management?

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Correct answer: D — Oral amoxicillin-clavulanate for 2–4 weeks

A chronic (>4 weeks) wet cough in a young child without red flags (failure to thrive, recurrent pneumonia, digital clubbing) is most consistent with protracted bacterial bronchitis (PBB). Australian guidelines recommend a 2–4 week course of amoxicillin-clavulanate. Resolution of cough with antibiotics confirms the diagnosis. If cough recurs, further investigation including HRCT may be warranted.

Reference: Thoracic Society of Australia and New Zealand – 2024 – Position Statement on Chronic Cough in Children