Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand

Chang, Anne B., Bell, Scott C., Byrnes, Cass A., Grimwood, Keith, Holmes, Peter W., King, Paul T., Kolbe, John, Landau, Louis I., Maguire, Graeme P., McDonald, Malcolm I., Reid, David W., Thien, Francis C., and Torzillo, Paul J. (2010) Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand. Medical Journal of Australia, 193 (6). pp. 356-365.

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Abstract

Consensus recommendations for managing chronic suppurative lung disease (CSLD) and bronchiectasis, based on systematic reviews, were developed for Australian and New Zealand children and adults during a multidisciplinary workshop.

The diagnosis of bronchiectasis requires a high-resolution computed tomography scan of the chest. People with symptoms of bronchiectasis, but non-diagnostic scans, have CSLD, which may progress to radiological bronchiectasis.

CSLD/bronchiectasis is suspected when chronic wet cough persists beyond 8 weeks. Initial assessment requires specialist expertise. Specialist referral is also required for children who have either two or more episodes of chronic (> 4 weeks) wet cough per year that respond to antibiotics, or chest radiographic abnormalities persisting for at least 6 weeks after appropriate therapy.

Intensive treatment seeks to improve symptom control, reduce frequency of acute pulmonary exacerbations, preserve lung function, and maintain a good quality of life. Antibiotic selection for acute infective episodes is based on results of lower airway culture, local antibiotic susceptibility patterns, clinical severity and patient tolerance. Patients whose condition does not respond promptly or adequately to oral antibiotics are hospitalised for more intensive treatments, including intravenous antibiotics.

Ongoing treatment requires regular and coordinated primary health care and specialist review, including monitoring for complications and comorbidities.

Chest physiotherapy and regular exercise should be encouraged, nutrition optimised, environmental pollutants (including tobacco smoke) avoided, and vaccines administered according to national immunisation schedules.

Individualised long-term use of oral or nebulised antibiotics, corticosteroids, bronchodilators and mucoactive agents may provide a benefit, but are not recommended routinely.

Item ID: 11988
Item Type: Article (Refereed Research - C1)
Keywords: lung disease
Additional Information:

Reproduced with permission from Medical Journal of Australia.

ISSN: 1326-5377
Date Deposited: 30 Sep 2010 22:55
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110203 Respiratory Diseases @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920115 Respiratory System and Diseases (incl. Asthma) @ 100%
Citation Count from Web of Science Web of Science 27
Downloads: Total: 34
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