There’s no doubt that bronchiectasis is becoming more recognised in clinical practice and evidence for its treatment is evolving, but questions remain around the burden of disease in Australia and the impact of long-term macrolides on bacterial resistance, Australian respiratory physicians say.
Writing in a review of the chronic lung condition published in this week’s MJA, Sydney-based respiratory physicians Dr Simone Visser, Professor Peter Bye, and Associate Professor Lucy Morgan said that historically non-CF related bronchiectasis was a disease that was neglected in research.
However, over the last five years research had gained worldwide momentum with the establishment of registries and at a national level, the setting up of the Australian Bronchiectasis registry in 2016 and the creation of a bronchiectasis-specific code added to the Australian Refined Diagnostic Related Group Classification system.
Given the evolving evidence base and increasing recognition of the disease a review of its management in adults was timely, the physicians said.
The goals of therapy are to improve symptoms, reduce exacerbations and limit progression of disease and effective airways clearance remained the cornerstone of management and should be managed and reviewed regularly by a respiratory physiotherapist, they noted.