I appreciate Dr. Marchant and Chang’s comments on my editorial1pointing out that although their study2was an important evaluation of cough in a large number of young children, the protocol that they chose was quite different from that validated in adults as described by Irwin and colleagues.3They included a number of children with a cough of < 8 weeks duration, and more importantly, they did not evaluate for upper airway cough syndrome, asthma, or gastroesophageal reflux as the major diagnosis noted in adults with chronic cough. These were also noted to be common causes of chronic cough in pediatric studies as well.4Because they chose a radically different approach to the diagnosis, it is impossible to know whether the children in their study had gastroesophageal reflux, asthma, or upper airways cough syndrome. By choosing bronchoscopy as their principal diagnostic test in these patients, the authors determined that 40% of the children had “prolonged bacterial bronchitis” (PBB), although these children did not have increased airway secretions. This is in contradistinction to a report5 that in adults PBB is associated with a large amount of airway secretions. This suggests that the “moist cough” they heard in these children could have been from upper airway secretions in the back of the child’s throat.