TY - JOUR
T1 - Challenges in managing Pseudomonas aeruginosa in non-cystic fibrosis bronchiectasis
AU - Wilson, Robert
AU - Aksamit, Timothy
AU - Aliberti, Stefano
AU - De Soyza, Anthony
AU - Elborn, J. Stuart
AU - Goeminne, Pieter C.
AU - Hill, Adam T.
AU - Menendez, Rosario
AU - Polverino, Eva
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background An Expert Forum was held at the 2014 European Respiratory Society International Congress to address issues involved in the management of Pseudomonas aeruginosa infection in patients with non-cystic fibrosis bronchiectasis (NCFB). Multiple studies have found that chronic P. aeruginosa infection is associated with more severe disease and higher morbidity and mortality. Overview Participants discussed appropriate management of P. aeruginosa infection at three stages: 1) first isolation, including eradication protocols; 2) during exacerbations; and 3) during chronic infection, including long-term antibiotic therapy to reduce the severity of symptoms and frequency of exacerbations. Topics covered included frequency of sputum cultures, antibiotic treatment at first isolation and for exacerbations, optimal use of inhaled antibiotics, indications for long-term therapy, and treatment regimens that may reduce the frequency or severity of symptoms. Electronic polling and roundtable discussions followed by expert insights were used to address these topics. Significant diversity in management practices was reported among different countries and centres, and in many cases clinical management was at variance with published guidelines. Conclusions This Expert Forum identified standardised terminology, clinician training, additional research into management strategies, and the development of new drugs as areas requiring improvement for the optimal management of P. aeruginosa in NCFB.
AB - Background An Expert Forum was held at the 2014 European Respiratory Society International Congress to address issues involved in the management of Pseudomonas aeruginosa infection in patients with non-cystic fibrosis bronchiectasis (NCFB). Multiple studies have found that chronic P. aeruginosa infection is associated with more severe disease and higher morbidity and mortality. Overview Participants discussed appropriate management of P. aeruginosa infection at three stages: 1) first isolation, including eradication protocols; 2) during exacerbations; and 3) during chronic infection, including long-term antibiotic therapy to reduce the severity of symptoms and frequency of exacerbations. Topics covered included frequency of sputum cultures, antibiotic treatment at first isolation and for exacerbations, optimal use of inhaled antibiotics, indications for long-term therapy, and treatment regimens that may reduce the frequency or severity of symptoms. Electronic polling and roundtable discussions followed by expert insights were used to address these topics. Significant diversity in management practices was reported among different countries and centres, and in many cases clinical management was at variance with published guidelines. Conclusions This Expert Forum identified standardised terminology, clinician training, additional research into management strategies, and the development of new drugs as areas requiring improvement for the optimal management of P. aeruginosa in NCFB.
KW - Airway inflammation
KW - Antibiotics
KW - Clinical management
KW - Lower airway infection
KW - Non-CF bronchiectasis
KW - Pseudomonas aeruginosa
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U2 - 10.1016/j.rmed.2016.06.007
DO - 10.1016/j.rmed.2016.06.007
M3 - Review article
AN - SCOPUS:84975780485
VL - 117
SP - 179
EP - 189
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
ER -