Bronchiectasis exacerbations in children: What predicts the response to antibiotics?
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 iden...
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ftgriffithuniv:oai:research-repository.griffith.edu.au:10072/404616 2024-06-23T07:52:52+00:00 Bronchiectasis exacerbations in children: What predicts the response to antibiotics? Goyal, V Marchant, J Grimwood, K Masters, B Yerkovich, S Chang, A 2021-05-01 to 2021-05-02 Virtual 2021 http://hdl.handle.net/10072/404616 English eng WILEY Respirology TSANZSRS 2021 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 https://onlinelibrary.wiley.com/doi/10.1111/resp.14021 http://hdl.handle.net/10072/404616 1323-7799 open access Biomedical and clinical sciences Health sciences Science & Technology Life Sciences & Biomedicine Respiratory System Conference output 2021 ftgriffithuniv 2024-05-29T00:06:29Z 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 ... Conference Object First Nations Griffith University: Griffith Research Online |
institution |
Open Polar |
collection |
Griffith University: Griffith Research Online |
op_collection_id |
ftgriffithuniv |
language |
English |
topic |
Biomedical and clinical sciences Health sciences Science & Technology Life Sciences & Biomedicine Respiratory System |
spellingShingle |
Biomedical and clinical sciences Health sciences Science & Technology Life Sciences & Biomedicine Respiratory System Goyal, V Marchant, J Grimwood, K Masters, B Yerkovich, S Chang, A Bronchiectasis exacerbations in children: What predicts the response to antibiotics? |
topic_facet |
Biomedical and clinical sciences Health sciences Science & Technology Life Sciences & Biomedicine Respiratory System |
description |
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 ... |
format |
Conference Object |
author |
Goyal, V Marchant, J Grimwood, K Masters, B Yerkovich, S Chang, A |
author_facet |
Goyal, V Marchant, J Grimwood, K Masters, B Yerkovich, S Chang, A |
author_sort |
Goyal, V |
title |
Bronchiectasis exacerbations in children: What predicts the response to antibiotics? |
title_short |
Bronchiectasis exacerbations in children: What predicts the response to antibiotics? |
title_full |
Bronchiectasis exacerbations in children: What predicts the response to antibiotics? |
title_fullStr |
Bronchiectasis exacerbations in children: What predicts the response to antibiotics? |
title_full_unstemmed |
Bronchiectasis exacerbations in children: What predicts the response to antibiotics? |
title_sort |
bronchiectasis exacerbations in children: what predicts the response to antibiotics? |
publisher |
WILEY |
publishDate |
2021 |
url |
http://hdl.handle.net/10072/404616 |
op_coverage |
2021-05-01 to 2021-05-02 Virtual |
genre |
First Nations |
genre_facet |
First Nations |
op_relation |
Respirology TSANZSRS 2021 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 https://onlinelibrary.wiley.com/doi/10.1111/resp.14021 http://hdl.handle.net/10072/404616 1323-7799 |
op_rights |
open access |
_version_ |
1802644289139769344 |