Antibiotics are indicated for acute exacerbations of mild to moderate bronchiectasis

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Goodfellow Gems

Antibiotics are indicated for acute exacerbations of mild to moderate bronchiectasis

Adult patients with acute exacerbations of mild to moderate bronchiectasis typically present with worsening of ≥ 3 key symptoms: cough, change in sputum colour, increase in sputum volume, fever, haemoptysis or malaise.

Treatment with antibiotics is indicated if Pseudomonas is not found in their sputum cultures (Pseudomonas requires specialist advice).1 Sputum cultures from previous samples are especially helpful.

The antibiotics chosen are usually sensitive to H. influenzae or S. aureus e.g. amoxicillin: 500mg orally tds (or higher) or doxycycline 100mg BD if allergies. 

If no previous bacteriology, first-line treatment is amoxicillin-clavulanic acid 625 mg tds until culture results available. Treatment is for 14 days.

Reference:

  1. British Thoracic Society Guideline for bronchiectasis in adults (2019) View here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.



As published in NZ Doctor 06/05/2020