Bronchiectasis/end stage lung disease
Eur Respir J 2024; 63: 2400518 [DOI: 10.1183/13993003.00518-2024].
- Permanent abnormal dilatation of bronchi and bronchioles due to repeated cycles of airway infection and inflammation, leading to chronic cough, sputum hypersecretion, wheeze and dyspnea.
- Diagnosis: high resolution CT showing dilated and thickened airways - investigate and treat possible causes; 50-80% of cases may be idiopathic.
- Antibiotics with good lung penetration:
- macrolides
- quinolones.
Acute exacerbation
- Sputum for bacterial and mycobacterial culture recommended.
Usual Pathogens
H. influenzae
P. aeruginosa
Other non-fermenting Gram negative bacilli
S. aureus/MRSA
S. pneumoniae
Nontuberculous mycobacteria
Aspergillus spp
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Tailor antibiotic to sputum C&S results | Optimal duration of therapy unknown - anywhere from 7-21 days has been recommended depending on pathogen and previous response to therapy |