CompletedInterventional

Comparison of lower airway sampling strategies in children with protracted bacterial bronchitis

Protracted bacterial bronchitis (PBB) is a lasting chest infection in young children that causes a persistent, wet cough. To choose the best antibiotic, doctors need to test mucus from deep in the lungs. At present, this usually requires a bronchoscopy—a camera test performed in hospital under general anaesthetic. This study tests whether two gentler methods work just as well: a quick throat swab taken while coughing, and breathing in a salty mist to bring up phlegm. Children aged 1 to 10 who are already booked for a bronchoscopy can take part. Taking part does not require any extra hospital visits or blood tests. The two gentle tests are done while waiting for the planned hospital procedure. By taking part, families help researchers discover if child-friendly, awake tests could replace the need for anaesthetics in the future, making care quicker, easier, and less stressful.

At a glance

Status

Completed

Sponsor

University Hospitals of North Midlands NHS Trust

Enrolment target

131

Start

29 Oct 2021

Estimated completion

31 Mar 2023

Protracted bacterial bronchitis

What is this study about?

Protracted bacterial bronchitis (PBB) is a common cause of a persistent chesty cough in young children. It can disrupt sleep, make daily play difficult, and lead to missed days at nursery or school. While antibiotics treat the infection, children often need several courses. To choose the most effective antibiotic and prevent germs from becoming resistant, doctors need to identify the exact bacteria causing the trouble.

Finding the right bug is challenging because young children rarely spit up phlegm on demand. Currently, the most accurate test is a flexible bronchoscopy. This involves passing a tiny camera into the lungs to collect a fluid washing while the child is asleep under general anaesthetic. Although bronchoscopy is safe, it requires specialist care, fasting, and a hospital stay, which can feel daunting for families.

Researchers are investigating whether two simple, awake tests can collect good mucus samples without an anaesthetic. These tests are a cough swab and an 'induced sputum' test, where the child breathes in a salty mist to loosen phlegm. If these gentler options work well, doctors may be able to test and treat children with PBB much faster and avoid unnecessary hospital procedures.

Key takeaways

Tests whether two gentle, awake methods can replace a camera test under anaesthetic.
Designed for children aged 1 to 10 already booked for a bronchoscopy for PBB.
Involves a quick cough swab and breathing in a salty mist before the main procedure.
Requires no needles, no blood tests, and no extra hospital trips.
Helps doctors find child-friendly ways to diagnose and treat persistent chest infections.

Who may be eligible?

This study is open to children aged 1 to 10 years who have protracted bacterial bronchitis (PBB) and are already scheduled to have a bronchoscopy as part of their normal NHS care. Parents or guardians must be happy to give informed consent for their child to join.

Children cannot take part if they have other long-term chest or immune conditions, such as cystic fibrosis, bronchiectasis, or an immunodeficiency.

Additionally, children cannot join if their bronchoscopy is being done as an emergency treatment (such as clearing a collapsed lung) rather than to look for infection, or if they are currently taking part in another clinical treatment trial.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

My child is between 1 and 10 years old.
My child has protracted bacterial bronchitis (PBB).
My child is already booked for an NHS bronchoscopy.
My child does not have cystic fibrosis, bronchiectasis, or an immune deficiency.
My child is not currently enrolled in another medical treatment study.

Answer every question to see your result.

What does participation involve?

Taking part happens entirely during your child's scheduled hospital visit for their bronchoscopy, so there are no extra appointments and no blood tests. You will simply be asked to arrive at the hospital a little earlier than usual on the day. While waiting for the main procedure, a specialist children's physiotherapist will carry out two quick sample collections. First, they will hold a soft cotton swab near the back of your child's throat for up to two minutes while encouraging them to cough. Second, your child will breathe in a harmless, salty mist from a nebuliser mask for up to 20 minutes while the physiotherapist gently taps their chest to help them cough up phlegm. Parents will be asked to fill in three very short questionnaires—taking about five minutes each—to share how well their child tolerated each procedure. Once the routine bronchoscopy and final questionnaire are complete, your child's participation ends.

Potential risks and benefits

Your child may not benefit directly from joining, but any bacteria discovered in the extra samples will be shared with their doctor to help tailor their treatment. The wider benefit is helping to develop kinder, easier tests for children with chest infections in the future. The tests carry very low risk. Breathing in the salty mist can cause temporary coughing or mild wheezing; if wheezing occurs, the team can quickly relieve it using a standard blue inhaler. Joining the study is completely voluntary, and choosing not to take part or withdrawing at any time will never affect your child's routine hospital care.

Locations (5)

Freeman Hospital
Approximate
Newcastle upon Tyne, England
Royal Stoke University Hospital
Approximate
Stoke-On-Trent, England
Sheffield Children's Hospital
Approximate
Sheffield, England
Manchester Royal Infirmary
Approximate
Manchester, England
Alder Hey Hospital
Approximate
Liverpool, England

Common questions

Will my child need any extra needles or blood tests?

No. The study only involves a throat swab and breathing in a mist. There are no blood tests or injections involved.

Do we need to make extra trips to the hospital?

No extra hospital visits are needed. The tests are completed on the same day your child is already booked in for their routine bronchoscopy.

Are the study tests painful?

No, the tests do not hurt. The cough swab may tickle or cause a brief gag, and the mist encourages coughing, but both are routinely used and generally well tolerated by young children.

What happens if the mist makes my child wheeze?

A trained children's physiotherapist is present throughout. If any wheezing happens, it settles quickly and can be treated immediately with puffs from a blue reliever inhaler.

Will taking part delay when my child can go home?

No. The short questionnaires can easily be filled out while your child is recovering in hospital and will not delay your discharge.

How to find out more

Francis Gilchrist

Francis.Gilchrist@uhnm.nhs.uk +44 (0)7815205459 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.