Table 2 Recommendations adopted with minor changes and those added to the clinical referral pathway for Primary Care Management of Bronchiectasis
Recommendations adopted with Minor Changes | ||
|---|---|---|
Original Recommendations | Recommendations Adopted with Minor Changes | |
“For P. aeruginosa colonised patients Consider azithromycin or erythromycin as an alternative (eg, if a patient does not tolerate inhaled antibiotics) to an inhaled antibiotic for patients with bronchiectasis and chronic P. aeruginosa infection. (B)” [27] | For P. aeruginosa colonised patients Consider azithromycin as an alternative (e.g., if a patient does not tolerate inhaled antibiotics) to an inhaled antibiotic for patients with bronchiectasis and chronic P. aeruginosa infection. (B) | |
“For P. aeruginosa colonised patients Consider azithromycin or erythromycin as an additive treatment to an inhaled antibiotic for patients with bronchiectasis and chronic P. aeruginosa infection who have a high exacerbation frequency. (D)” [27] | For P. aeruginosa colonised patients Consider azithromycin as an additive treatment to an inhaled antibiotic for patients with bronchiectasis and chronic P. aeruginosa infection who have a high exacerbation frequency. (D) | |
“For non-P. aeruginosa colonised patients Use azithromycin or erythromycin for patients with bronchiectasis. (A)” [27] | For non-P. aeruginosa colonised patients Use azithromycin for patients with bronchiectasis. (A) | |
“For non-P. aeruginosa colonised patients Consider inhaled gentamicin as a second line alternative to azithromycin or erythromycin. (B)” [27] | For non-P. aeruginosa colonised patients Consider inhaled gentamicin as a second line alternative to azithromycin. (B) | |
Added Recommendation | Source | |
“Look for signs and symptoms (chronic productive cough with purulent or mucopurulent sputum, recurrent chest infections and shortness of breath) that raise suspicion towards a diagnosis of bronchiectasis” | ||
“Assess risk factors – modifiable (smoking) and non-modifiable (pre-existing conditions like cystic fibrosis, immunodeficiency disorders, connective tissue disorders, ABPA and recent severe pneumonia) – for bronchiectasis” | NIH National Heart, Lung and Blood Institute [41] | |
“For adult patients with no suspicious signs and symptoms aligning with bronchiectasis, but with significant risk factors towards developing it, offer counselling regarding the modifiable risk factors, in this case - smoking. Recommend cessation of smoking and avoiding inhaling secondhand smoke, if applicable.” | ||