P125 Chronic suppurative lung disease in children – characterisation of a tertiary paediatric hospital cohort

BackgroundChronic suppurative lung diseases (CSLDs) comprise lung diseases characterised by chronic productive cough, compromised airway clearance and poor long-term health. Evidence is sparse regarding the best quality of care. We aimed to characterise a paediatric cohort of CSLD, provide epidemiological evidence on risk factors and current management.MethodsCSLD patients (age 0–16) were identified from tertiary paediatric hospital respiratory clinics between 01/2009–06/2019. A database including medical and social history, investigations and treatments was established. Anonymised data were analysed using Microsoft-Excel, MATLAB and SPSS. An intensity map of CSLD prevalence based on the patients’ postcodes was built and linked to an index of multiple deprivation.Results110 children were included (n=62, 56% male). Most initially presented with chronic wet cough (n=63, 57%) and final diagnoses included non-CF bronchiectasis (n=36, 33%), protracted bacterial bronchitis (PBB) (n=20, 18%) and primary ciliary dyskinesia (n=7, 6%).Univariate analysis indicated a family history of respiratory problems as a risk factor for a diagnosis of non-CF bronchiectasis (p=0.027) and PBB (p=0.047). An infectious aetiology was common in this cohort overall and was significantly associated with a diagnosis of non-CF bronchiectasis (p=0.002) but not PBB (p=0.233).Long-term prophylactic azithromycin was prescribed in 69% (n=76) of children. Kaplan-Meier method showed that patients prescribed prophylactic antibiotics remained in tertiary care follow-up for longer (figure 1). Symptoms resolved in 21 children during follow-up and 62% (n=13) in that group were prescribed prophylactic azithromycin.Physiotherapy was recommended in 76 cases (69%), with 24 (32%) using mucolytic agents, nearly half (n=13) using DNase. 67% of patients were on the least deprived end of the socioeconomic spectrum. Certain postcode areas showed significantly higher prevalence.Abstract P125 Figure 1Kaplan-Meier survival curve showing the cumulative probability of the patients‘ symptoms resolving with or without prophylactic antibiotics during the time of follow-up clinics. Log Rank (Mantel-Cox) statistics p= 0.001ConclusionAzithromycin and DNase were frequently used despite some international guidelines suggesting otherwise. Prophylactic azithromycin use was common in children with or without symptom resolution and prophylaxis was significantly associated with a longer follow-up, raising questions about what