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Preliminary Guidelines for Adult Bronchiectasis
MAC & Bronchiectasis | Last Active: Oct 31 11:34am | Replies (21)Comment receiving replies
Thank you, Linda. Can you post these preliminary guidelines?
Replies to "Thank you, Linda. Can you post these preliminary guidelines?"
@tcd518 I just googled "North American guidelines for adult bronchiectasis" and pertinent info came up. Does look similar to European guidelines. It's interesting how long-term macrolides are recommended during exasperations. Over the past 4-5 few years (prior to my 2024 NTM diagnosis), I have requested Azithromycin solely for its effectiveness-not knowing anything about bronchiectasis guidelines, only that they got rid of my fatigue and inflammation. I would tell the doctors, nothing else works. Now, I am concerned that following the European and now, NA guidelines could cause NTM to become macrolide resistant. Seems like a catch-22.
@tcd518 this article was posted by a reporter who attended the conference:
https://www.ajmc.com/view/guidelines-for-bronchiectasis-highlight-multiple-treatment-methods
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@tcd518 I expect the US Guidelines will be similar to the European Guidelines released earlier this summer.
Here is the (very lengthy) article from the ERS Journal:
https://publications.ersnet.org/content/erj/early/2025/09/18/13993003.01126-2025.full.pdf
PICO questions begin on page 21. These lead into the GRADE (Grading of Recommendations,
Assessment, Development and Evaluations) analysis of treatment recommendations.
For those wishing for a list of specific recommendations, you may be disappointed, as these are somewhat different, and leave much of the decision-making to the patient-doctor team. That is fine is you are working with a highly expert pulmonologist, but the language in the tables may lead other doctors (and insurance companies) to balk at some recommendations.
For example, see PQ1, on Airway clearance, under the Summary of Recommendations staring on page 10. An inexperienced doc looking at this may shrug at Airway Clearance, while one who sees the evidence every day knows well its value.
In summary, we will undoubtedly find that what the experts already do is pretty well supported, but the medical community needs to figure out how to communicate this CONCISELY to a broader group of doctors, because not everyone has access to the experts.