British Thoracic Society guideline for bronchiectasis in adults

Adam T Hill, Anita L Sullivan, James D Chalmers, Anthony De Soyza, J Stuart Elborn, R Andres Floto, Lizzie Grillo, Kevin Gruffydd-Jones, Alex Harvey, Charles S Haworth, Edwin Hiscocks, John R Hurst, Christopher Johnson, W Peter Kelleher, Pallavi Bedi, Karen Payne, Hesham Saleh, NIcholas J Screaton, Maeve Smith, Michael Tunney, Deborah Whitters, Robert Wilson, Michael R Loebinger, Adam T Hill, Anita L Sullivan, James D Chalmers, Anthony De Soyza, J Stuart Elborn, R Andres Floto, Lizzie Grillo, Kevin Gruffydd-Jones, Alex Harvey, Charles S Haworth, Edwin Hiscocks, John R Hurst, Christopher Johnson, W Peter Kelleher, Pallavi Bedi, Karen Payne, Hesham Saleh, NIcholas J Screaton, Maeve Smith, Michael Tunney, Deborah Whitters, Robert Wilson, Michael R Loebinger

Abstract

The full British Thoracic Society Guideline for Bronchiectasis in Adults is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline. The appendices are available in the full guideline.

Keywords: bronchiectasis.

Conflict of interest statement

Competing interests: All authors have completed a declaration of interest form in line with BTS Policy and copies are available from BTS head office on request. JC has declared funding from Bayer Healthcare, Griffols, Pfizer, Insmed, Chiesi, Boehringer Ingelheim, GlaxoSmithkline, Astra Zeneca, Napp. ADS has declared funding from Bayer Healthcare, Pfizer, Insmed, Boehringer Ingelheim, Astra Zeneca. SE has declared funding from GlaxoSmithKline. AF has declared funding from GlaxoSmithKline, Zambon, Insmed, Verona. KGJ has declared funding from Boehringer Ingelheim, GlaxoSmithkline, Astra Zeneca, Napp, TEVA, Chiesi, Nutricia, Novartis. CSH has declared funding from Aradigm, Gilead, Griffols, Insmed, Chiesi, GlaxoSmithkline, TEVA, Vertex, Zambon, Novartis. ATH has declared funding from Bayer Healthcare, Boehringer Ingelheim. JRH has declared funding from Pfizer. MRL has declared funding from Bayer Healthcare, Insmed, Pulmocide, Griffols, Polyphor, Savara. MT has declared funding from Novartis, Basilea, Stragen. RW has declared funding from Bayer Healthcare.

Figures

Figure 1
Figure 1
Management of the deteriorating patient.
Figure 2
Figure 2
Stepwise management. Antibiotics are used to treat exacerbations that present with an acute detrioration (usually over several days) with worsening local symptoms (cough, increased sputum volume or change of viscoisity, increased sputum purulence with or without increasing wheeze, breathlessness, haemoptypsis) and/or systemic upset. The flow diagram refers to three or more annual exacerbations.
Figure 3
Figure 3
Physiotherapy management - stepwise airway clearance.
Figure 4
Figure 4
Airway clearance - exacerbations.
Figure 5
Figure 5
Algorithm for initial assessment and treatement - rhinosinusitis.

References

    1. Hill AT, Sullivan AL, Chalmers JD, et al. . BTS Guideline for bronchiectasis in adults. Thorax 2019;74(Suppl 1).
    1. Hill AT, Welham SA, Sullivan AL, et al. . Updated BTS Adult Bronchiectasis Guideline 2018: a multidisciplinary approach to comprehensive care. Thorax 2019;74.
    1. Haworth C. BTS Guideline on the management of non-tuberculous mycobacterial pulmonary disease. Thorax 2017;72 (Suppl 2).
    1. Morice AH, McGarvey L, Pavord I, et al. . Recommendations for the management of cough in adults. Thorax 2006;61(suppl_1):i1–i24.
    1. NICE , 2014. Gastro-oesophageal reflux disease and dyspepsia in adults. Available from:

Source: PubMed

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