How do you define a Bronchiectasis Exacerbation?

This question seems to arise often - and as we approach school opening and indoor season for much of the country, colds, flu and other viruses begin to take their toll.

What is an exacerbation of Bronchiectasis?
An INCREASE in three or more symptoms from the list below, which lasts for at least 48 hours.
- cough
- sputum volume and / or consistency
- sputum purulence (color)
- breathlessness and / or reduced exercise tolerance
- fatigue and / or malaise
- hemoptysis (coughing up blood)

Is every cold or viral infection an exacerbation?
Not necessarily. You may be tired and achy, have a cough and a runny, stuffy nose. That is only two of the 3 - not an exacerbation. But, keep in mind your resistance is compromised, so you could get worse.

Can you get an exacerbation if you are on antibiotics for NTM/MAC.
Yes, if you get the flu, pneumonia, RSV, Covid or another infection, you can get an exacerbation.

What should you do if you have an exacerbation?
Contact your pulmonologist as soon as you realize it - even if you are on other antibiotics. If you get worse, you may need more intervention, including other medications, different/more nebulizer treatments, oxygen or even hospitalization.
Use the ER or Urgent Care only if your doctor is unavailable or directs you there - lacking your complete medical record, they will only be able to provide care "to standard" and you may need more.

If you have frequent exacerbations or if you plan to travel, it is a good idea to set up an "emergency plan" with your pulmonologist. This will cover when to start additional meds, and treatments. Some doctors even provide a supply of steroids and/or antibiotics to have on hand in case of an exacerbation, with instructions when to start using them.