Chronic Bronchitis in Childhood: What Is It?

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Abstract
According to national statistics, over 2.5 million children have chronic bronchitis (CB). The characteristics of childhood CB and the similarities to the adult form are unknown. To determine the conditions under which childhood CB is diagnosed and to evaluate how it is treated, questionnaires were sent to 103 pediatricians and family physicians in Tucson. Forty-five percent responded. A chronic productive cough lasting at least three months a year was important for the diagnosis of CB for only 55% of pediatricians and 74% of family physicians. Recurrent episodes of cough lasting more than two weeks were important for the diagnosis of CB for 86% pediatricians. Sputum production was important for the diagnosis for about 50% of physicians, whereas wheezing was considered an important diagnostic criterion for nearly 60% of physicians. Most physicians felt that allergies were a common cause of childhood CB and bronchodilators were commonly used to treat CB. The results of this survey suggest that: (1) the diagnosis of CB in childhood is not often based on the usual epidemiologic criteria used for diagnosing CB in adults; and (2) CB in childhood may have considerable overlap with asthma with respect to etiology, pathophysiology, and treatment. In fact, for many children, there appear to be few ways to distinguish asthma from CB.