Bronchiectasis Flashcards
(11 cards)
What is bronchiectasis?
A chronic condition characterized by permanent dilation of the bronchi due to inflammatory damage to the airway walls.
What are hallmark symptoms of bronchiectasis?
Daily cough with large amounts of purulent sputum, breathlessness, haemoptysis, chest pain (non-pleuritic), coarse crackles, wheeze, rhonchi, and high-pitched inspiratory squeaks.
When should bronchiectasis be suspected in adults?
Persistent productive cough (>8 weeks), frequent COPD exacerbations, history of rheumatoid arthritis, inflammatory bowel disease, or non-smoker with COPD and frequent exacerbations.
When should bronchiectasis be suspected in children?
Chronic wet cough unresponsive to antibiotics, recurrent or non-resolving pneumonia, unexplained haemoptysis, or structural airway abnormalities.
What is first-line empirical antibiotic treatment for adults with an acute exacerbation?
Amoxicillin 500 mg three times daily for 7–14 days.
What are antibiotic alternatives for penicillin-allergic adults?
Clarithromycin or doxycycline.
What non-pharmacological intervention is essential during exacerbations?
Airway clearance techniques (ideally guided by a physiotherapist).
Should inhaled corticosteroids be used routinely in bronchiectasis?
No, only if there is another indication (e.g. asthma or COPD).
When should antibiotic prophylaxis be considered in bronchiectasis?
In patients with 3 or more exacerbations per year, under specialist care.
What macrolide regimens are used for prophylaxis in adults?
Azithromycin 250 mg daily or 500 mg three times weekly; erythromycin 400 mg twice daily.
What is the first-line treatment for Pseudomonas aeruginosa infection in bronchiectasis?
Inhaled colistin.
