European Respiratory Society clinical practice guideline for the management of adult bronchiectasis

作者：James Duncan Chalmers, Charles Haworth, Patrick A. Flume, Merete Bridget Long, Pierre‐Régis Burgel, Katerina Dimakou, Francesco Blasi, Beatriz Herrero‐Cortina, Raja Dhar, Sanjay Haresh Chotirmall, Felix C. Ringshausen, Josje Altenburg, Lucy C. Morgan, Mattia Nigro, Megan Louise Crichton, Chayenne Van Meel, Oriol Sibila, Alan Timothy, Eliza Kompatsiari, Tanja Hedberg, Thomas Vandendriessche, Pamela J. McShane, Thomy Tonia, Kevin L. Winthrop, Michael R. Loebinger, Natalie Lorent, Pieter Goeminne, Michal Shteinberg, Eva Polverino, Stefano Aliberti · 发表于：European Respiratory Journal · 年份：2025 · DOI：10.1183/13993003.01126-2025 · 被引用次数：128 · 研究领域：Cystic Fibrosis Research Advances、Neonatal Respiratory Health Research、Chronic Obstructive Pulmonary Disease (COPD) Research

Background Bronchiectasis is a common lung condition associated with wide range of infectious, immunological, autoimmune, allergic and genetic conditions. Exacerbations and daily symptoms have the largest impact on patients and healthcare systems, and they are the key focus of treatments. Current practice is heterogeneous globally, and bronchiectasis has historically been a neglected disease. Here, we present evidence-based international guidelines for the management of adults with bronchiectasis. Methods A European Respiratory Society (ERS) Task Force, comprising global experts, a methodologist and patient representatives, developed clinical practice guidelines in accordance with ERS methodology and the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. Systematic literature searches, data extraction and meta-analysis were performed to generate evidence tables, and recommendations were formulated using the evidence-to-decision framework. A total of eight PICO (Patients, Intervention, Comparator, Outcomes) questions and three narrative questions were developed. Recommendations The Task Force recommendations include strong recommendations in favour of airway clearance techniques for most patients with bronchiectasis, and pulmonary rehabilitation for those with impaired exercise capacity. We issue a strong recommendation for the use of long-term macrolide treatment for patients at high risk of exacerbations and a strong recommendation in favou...