LEAP-Cough: Long-term treatment with azithromycin to prevent bronchiectasis and recurrent cough

Synopsis

Why the research project is important

Chronic wet cough is one of the most common symptoms of chronic lung disease. In children, it is associated with bronchiectasis, recurrent doctor visits and impaired quality-of-life. Early diagnosis/treatment leads to decreased cost and, improved quality-of-life and clinical outcomes.

Yet, there is currently no published data on treatable traits in children with chronic wet cough or intervention that prevents bronchiectasis. Our consumer co-designed proposal fulfils identified unmet clinical need and research gaps.

What the research seeks to do

We plan a cohort study on 400 children with chronic wet cough. We will link carefully collected clinical characteristics with novel omics data obtained from blood and airway specimens using state-of-the-art technology.

Within this cohort, we will embed a multi-centre (5 sites), randomised controlled trial (RCT) focused on children who have high-risk traits for poorer outcomes, informed by our prior 5-yr cohort study. Our RCT aims are to prevent bronchiectasis and other clinical outcomes of children with chronic wet cough who have high-risk trait.

What are the research outcomes/ impact

If our RCT hypothesis based on clinical traits is true, results will change clinical practice. Reducing protracted bacterial bronchitis and/or bronchiectasis will lead to substantial health and quality-of-life improvements, and reduction of antibiotic use, days off school or work and resource use. It will also lead to overall better longer-term clinical and lung function outcomes.

Also, our study will provide novel pheno-endotypes and biomarkers data that is currently non-existent in this field.