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Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand

Chang, Anne B., Bell, Scott C., Byrnes, Cass A., Grimwood, Keith, Holmes, Peter W., King, Paul T., Kolbe, John, Landau, Louis I., Maguire, Graeme P., McDonald, Malcolm I., Reid, David W., Thiens, Francis C. and Torzillo, Paul J. (2010). Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand. Medical Journal of Australia,193(6):356-365.

Document type: Journal Article
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IRMA ID 81704288xPUB409
NHMRC Grant No. 389837
Title Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand
Author Chang, Anne B.
Bell, Scott C.
Byrnes, Cass A.
Grimwood, Keith
Holmes, Peter W.
King, Paul T.
Kolbe, John
Landau, Louis I.
Maguire, Graeme P.
McDonald, Malcolm I.
Reid, David W.
Thiens, Francis C.
Torzillo, Paul J.
Journal Name Medical Journal of Australia
Publication Date 2010
Volume Number 193
Issue Number 6
ISSN 0025-729X   (check CDU catalogue open catalogue search in new window)
Start Page 356
End Page 365
Total Pages 10
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C2 - Journal Article - Other contributions to refereed journal (internal)
Abstract •Consensus recommendations for managing chronic suppurative lung disease (CSLD) and bronchiectasis, based on systematic reviews, were developed for Australian and New Zealand children and adults during a multidisciplinary workshop.

•The diagnosis of bronchiectasis requires a high-resolution computed tomography scan of the chest. People with symptoms of bronchiectasis, but non-diagnostic scans, have CSLD, which may progress to radiological bronchiectasis.

•CSLD/bronchiectasis is suspected when chronic wet cough persists beyond 8 weeks. Initial assessment requires specialist expertise. Specialist referral is also required for children who have either two or more episodes of chronic (> 4 weeks) wet cough per year that respond to antibiotics, or chest radiographic abnormalities persisting for at least 6 weeks after appropriate therapy.

•Intensive treatment seeks to improve symptom control, reduce frequency of acute pulmonary exacerbations, preserve lung function, and maintain a good quality of life.

•Antibiotic selection for acute infective episodes is based on results of lower airway culture, local antibiotic susceptibility patterns, clinical severity and patient tolerance. Patients whose condition does not respond promptly or adequately to oral antibiotics are hospitalised for more intensive treatments, including intravenous antibiotics.

•Ongoing treatment requires regular and coordinated primary health care and specialist review, including monitoring for complications and comorbidities.

•Chest physiotherapy and regular exercise should be encouraged, nutrition optimised, environmental pollutants (including tobacco smoke) avoided, and vaccines administered according to national immunisation schedules.

•Individualised long-term use of oral or nebulised antibiotics, corticosteroids, bronchodilators and mucoactive agents may provide a benefit, but are not recommended routinely.

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