Robert Wilson1, Timothy Aksamit2, Stefano Aliberti3, Anthony De Soyza4, J Stuart Elborn5, Pieter Goeminne6, Adam T Hill7, Rosario Menendez8, Eva Polverino9. 1. Host Defence Unit, Royal Brompton Hospital, London, UK. Electronic address: r.wilson@rbht.nhs.uk. 2. Mayo Clinic, Pulmonary Disease and Critical Care Medicine, Rochester, MN, USA. 3. Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Newcastle University and Freeman Hospital, Newcastle Upon Tyne, UK. 5. Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK. 6. University Hospital of Gasthuisberg, Department of Respiratory Disease, Leuven, Belgium; Department of Respiratory Disease, AZ Nikolaas, St-Nikolaas, Belgium. 7. Department of Respiratory Medicine Royal Infirmary of Edinburgh and the University of Edinburgh, Edinburgh, UK. 8. Pneumology Department, Hospital Universitario y politecnico La Fe, CIBERES, Valencia, Spain. 9. Fundaciò Clinic, IDIBAPS, CIBERES, Hospital Clinic de Barcelona, Barcelona, Spain.
Abstract
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.
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.
Authors: Christopher M Blanchette; Joshua M Noone; Glenda Stone; Emily Zacherle; Ripsi P Patel; Reuben Howden; Douglas Mapel Journal: Med Sci (Basel) Date: 2017-09-23
Authors: Hamdan Al-Jahdali; Abdullah Alshimemeri; Abdullah Mobeireek; Amr S Albanna; Nehad N Al Shirawi; Siraj Wali; Khaled Alkattan; Abdulrahman A Alrajhi; Khalid Mobaireek; Hassan S Alorainy; Mohamed S Al-Hajjaj; Anne B Chang; Stefano Aliberti Journal: Ann Thorac Med Date: 2017 Jul-Sep Impact factor: 2.219
Authors: Sally Spencer; Lambert M Felix; Stephen J Milan; Rebecca Normansell; Pieter C Goeminne; James D Chalmers; Tim Donovan Journal: Cochrane Database Syst Rev Date: 2018-03-27