Bronchiectasis Exacerbations: Clinical Relevance and Management
M. Aurora Mendes 1, Amelia Shoemark 2, James D. Chalmers 3
1 Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; 2 Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland; 3 Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdomn
*Correspondence: Amelia Shoemark, Email not available
Abstract
Bronchiectasis is a clinico-radiological syndrome with variable course. Some patients are stable for years and others develop frequent exacerbations, characterised by symptoms such as increased cough and change in sputum and/or systemic features. Bacterial infections are the most frequent recognised trigger, and consequently the majority of these events are treated with systemic antibiotics. As a major cause of morbidity, mortality and healthcare related costs, exacerbations have been used as primary outcomes in clinical trials of new treatments in bronchiectasis. Furthermore, implementing prevention strategies in patients at risk of future exacerbations is a major goal of bronchiectasis management. However, evidence-based knowledge on bronchiectasis exacerbations is limited and there is no specific licensed-treatment. Further studies using the recently developed consensus-based definition are needed to clarify the unanswered questions regarding the pathophysiology, prevention and treatment of bronchiectasis exacerbations. This review summarises the existing evidence and the gaps in our knowledge of bronchiectasis exacerbations.Bronchiectasis is a clinico-radiological syndrome with variable course. Some patients are stable for years and others develop frequent exacerbations, characterised by symptoms such as increased cough and change in sputum and/or systemic features. Bacterial infections are the most frequent recognised trigger, and consequently the majority of these events are treated with systemic antibiotics. As a major cause of morbidity, mortality and healthcare related costs, exacerbations have been used as primary outcomes in clinical trials of new treatments in bronchiectasis. Furthermore, implementing prevention strategies in patients at risk of future exacerbations is a major goal of bronchiectasis management. However, evidence-based knowledge on bronchiectasis exacerbations is limited and there is no specific licensed-treatment. Further studies using the recently developed consensus-based definition are needed to clarify the unanswered questions regarding the pathophysiology, prevention and treatment of bronchiectasis exacerbations. This review summarises the existing evidence and the gaps in our knowledge of bronchiectasis exacerbations.
