European Respiratory Society guidelines for the management of adult bronchiectasis.
Eva PolverinoPieter C GoeminneMelissa J McDonnellStefano AlibertiSara E MarshallMichael R LoebingerMarlene MurrisRafael CantónAntoni TorresKaterina DimakouAnthony De SoyzaAdam T HillCharles S HaworthMontserrat VendrellFelix C RingshausenDragan SuboticRobert WilsonJordi VilaróBjorn StallbergTobias WelteGernot RohdeFrancesco BlasiStuart ElbornMarta AlmagroAlan TimothyThomas RuddyThomy ToniaDavid RigauJames D ChalmersPublished in: The European respiratory journal (2017)
Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy.These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes.
Keyphrases
- cystic fibrosis
- end stage renal disease
- clinical trial
- primary care
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- chronic obstructive pulmonary disease
- clinical practice
- systematic review
- type diabetes
- palliative care
- randomized controlled trial
- quality improvement
- patient reported outcomes
- metabolic syndrome
- adipose tissue
- insulin resistance
- helicobacter pylori infection
- candida albicans
- respiratory tract