Bronchiectasis

Treatment indicated if there are signs of infection e.g.

  • change in sputum colour/volume,
  • increased dyspnoea
  • increased cough
  • fever
  • increased wheeze
  • fatigue
  • change in clinical signs.

 

Sputum culture essential to identify causative organism

Initial treatment following sputum culture: previous cultures and sensitivities should guide antibiotic choice.

  • Review the response to empirical treatment when sputum culture and sensitivity results are available.:
  • If good response, continue with the prescribed antibiotic + do not change the treatment based on the culture results.
  • If poor or no response, prescribe a different antibiotic, guided by the results of sputum culture and sensitivity testing.

Consider bronchodilators and ensure expectoration techniques are being carried out. Home antibiotic therapy (IV or nebulised) or long term azithromycin therapy should only be commenced after consultation with Respiratory Physician

No previous microbiology:

PO amoxicillin

500mg TDS

14 Days

or PO clarithromycin

(should not be used in patients receiving treatment long term with azithromycin)

500mg BD

14 Days

P.aeruginosa colonisation: PO ciprofloxacin

500md BD

14 Days

Other organisms:

Refer to CKS Bronchiectasis Scenario: Infective exacerbation Table 1

or

discuss with microbiologist.