Abstract

HERNANDEZ-ZENTENO, Rafael de Jesús; VELAZQUEZ-MONTERO, Alejandra; SUAREZ-LANDA, Teresa de Jesús  and  PEREZ-PADILLA, José Rogelio. Recommendations for diagnostic approach and management of bronchiectasias. Neumol. cir. torax [online]. 2022, vol.81, n.4, pp.232-245.  Epub Feb 19, 2024. ISSN 0028-3746.  https://doi.org/10.35366/112952.

Bronchiectasis is a syndrome of chronic cough and production of viscous sputum associated with dilation of the airways and thickening of the bronchial wall. Exacerbations are usually caused by bacterial infections. It is a chronic disease that requires rapid responses for the treatment of exacerbations. Bronchial secretions should be cultivated. Evaluate and treat underlying diseases to interrupt progression. In patients who have recurrent exacerbations (two to three in the last year) and do not have Pseudomonas aeruginosa infection, preventive therapy with a macrolide is recommended, excluding nontuberculous mycobacterial infections. In patients with recurrent exacerbations, or significant morbidity, and Pseudomonas aeruginosa in sputum, a therapeutic trial of nebulized tobramycin is useful. Nebulized tobramycin may also be for patients not infected with Pseudomonas aeruginosa in whom oral antibiotic prophylaxis is contraindicated, not tolerated, or ineffective. Patients who have Pseudomonas aeruginosa but cannot receive a nebulized antibiotic may benefit from macrolides as an alternative. Inhaled glucocorticoids are only indicated in patients with asthma or COPD. For patients who respond to bronchodilators on spirometry, the use of inhaled beta-adrenergic agents is suggested. All patients are candidates for pulmonary rehabilitation and bronchial hygiene. The prognosis is influenced by the underlying disease process, the frequency of exacerbations, and comorbidities, but in general, age-adjusted mortality is increased compared with the general population.

Keywords : bronchiectasis; approach; diagnosis; treatment.

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