British Thoracic Society guideline for bronchiectasis in adults

Adam T Hill¹, Anita L Sullivan², James D Chalmers³, Anthony De Soyza⁴, J Stuart Elborn⁵, R Andres Floto^{6

7}, Lizzie Grillo⁸, Kevin Gruffydd-Jones⁹, Alex Harvey¹⁰, Charles S Haworth⁷, Edwin Hiscocks¹¹, John R Hurst¹², Christopher Johnson⁷, W Peter Kelleher^{13

14

15}, Pallavi Bedi¹⁶, Karen Payne¹⁷, Hesham Saleh⁵, NIcholas J Screaton¹⁸, Maeve Smith¹⁹, Michael Tunney²⁰, Deborah Whitters²¹, Robert Wilson¹⁴, Michael R Loebinger¹⁴

Affiliations

¹ Respiratory Medicine, Royal Infirmary of Edinburgh, and University of Edinburgh, Edinburgh, UK.
² Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust (Queen Elizabeth Hospital), Birmingham, UK.
³ Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital, Dundee, UK, Dundee, UK.
⁴ Institute of Cellular Medicine, NIHR Biomedical Research Centre for Aging and, Freeman Hospital Adult Bronchiectasis Service, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
⁵ Royal Brompton Hospital and Imperial College London, and Queens University Belfast, London, UK.
⁶ Department of Medicine, University of Cambridge, Cambridge, UK.
⁷ Cambridge Centre for Lung Infection, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
⁸ Royal Brompton Hospital, London, UK.
⁹ Box Surgery, Box, Wiltshire, UK.
¹⁰ Department of Clinical Sciences, Brunel University, London, UK.
¹¹ Coventry, Coventry, UK.
¹² UCL Respiratory, University College London, London, UK.
¹³ Centre for Immunology and Vaccinology, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
¹⁴ Host Defence Unit, Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
¹⁵ Chest and Allergy Clinic, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
¹⁶ MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK.
¹⁷ Glenfield Hospital, Leicester, UK.
¹⁸ Department of Radiology, Royal Papworth Hospital, Cambridge, UK.
¹⁹ University of Alberta, Edmonton, Canada.
²⁰ School of Pharmacy, Queens University, Belfast, UK.
²¹ Queen Elizabeth University Hospital, Glasgow, UK.

PMID: 30687502
PMCID: PMC6326298
DOI: 10.1136/bmjresp-2018-000348

British Thoracic Society guideline for bronchiectasis in adults

Adam T Hill et al. BMJ Open Respir Res. 2018.

. 2018 Dec 28;5(1):e000348.

doi: 10.1136/bmjresp-2018-000348. eCollection 2018.

Authors

Affiliations

¹ Respiratory Medicine, Royal Infirmary of Edinburgh, and University of Edinburgh, Edinburgh, UK.
² Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust (Queen Elizabeth Hospital), Birmingham, UK.
³ Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital, Dundee, UK, Dundee, UK.
⁴ Institute of Cellular Medicine, NIHR Biomedical Research Centre for Aging and, Freeman Hospital Adult Bronchiectasis Service, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
⁵ Royal Brompton Hospital and Imperial College London, and Queens University Belfast, London, UK.
⁶ Department of Medicine, University of Cambridge, Cambridge, UK.
⁷ Cambridge Centre for Lung Infection, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
⁸ Royal Brompton Hospital, London, UK.
⁹ Box Surgery, Box, Wiltshire, UK.
¹⁰ Department of Clinical Sciences, Brunel University, London, UK.
¹¹ Coventry, Coventry, UK.
¹² UCL Respiratory, University College London, London, UK.
¹³ Centre for Immunology and Vaccinology, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
¹⁴ Host Defence Unit, Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
¹⁵ Chest and Allergy Clinic, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
¹⁶ MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK.
¹⁷ Glenfield Hospital, Leicester, UK.
¹⁸ Department of Radiology, Royal Papworth Hospital, Cambridge, UK.
¹⁹ University of Alberta, Edmonton, Canada.
²⁰ School of Pharmacy, Queens University, Belfast, UK.
²¹ Queen Elizabeth University Hospital, Glasgow, UK.

PMID: 30687502
PMCID: PMC6326298
DOI: 10.1136/bmjresp-2018-000348

Abstract

The full British Thoracic Society Guideline for Bronchiectasis in Adults is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline. The appendices are available in the full guideline.

Keywords: bronchiectasis.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed a declaration of interest form in line with BTS Policy and copies are available from BTS head office on request. JC has declared funding from Bayer Healthcare, Griffols, Pfizer, Insmed, Chiesi, Boehringer Ingelheim, GlaxoSmithkline, Astra Zeneca, Napp. ADS has declared funding from Bayer Healthcare, Pfizer, Insmed, Boehringer Ingelheim, Astra Zeneca. SE has declared funding from GlaxoSmithKline. AF has declared funding from GlaxoSmithKline, Zambon, Insmed, Verona. KGJ has declared funding from Boehringer Ingelheim, GlaxoSmithkline, Astra Zeneca, Napp, TEVA, Chiesi, Nutricia, Novartis. CSH has declared funding from Aradigm, Gilead, Griffols, Insmed, Chiesi, GlaxoSmithkline, TEVA, Vertex, Zambon, Novartis. ATH has declared funding from Bayer Healthcare, Boehringer Ingelheim. JRH has declared funding from Pfizer. MRL has declared funding from Bayer Healthcare, Insmed, Pulmocide, Griffols, Polyphor, Savara. MT has declared funding from Novartis, Basilea, Stragen. RW has declared funding from Bayer Healthcare.

Figures

**Figure 1**
Management of the deteriorating patient.

**Figure 2**
Stepwise management. Antibiotics are used to treat exacerbations that present with an acute detrioration (usually over several days) with worsening local symptoms (cough, increased sputum volume or change of viscoisity, increased sputum purulence with or without increasing wheeze, breathlessness, haemoptypsis) and/or systemic upset. The flow diagram refers to three or more annual exacerbations.

**Figure 3**
Physiotherapy management - stepwise airway clearance.

**Figure 4**
Airway clearance - exacerbations.

**Figure 5**
Algorithm for initial assessment and treatement - rhinosinusitis.

See this image and copyright information in PMC

References

1. Hill AT, Sullivan AL, Chalmers JD, et al. . BTS Guideline for bronchiectasis in adults. Thorax 2019;74(Suppl 1). - PubMed
1. Hill AT, Welham SA, Sullivan AL, et al. . Updated BTS Adult Bronchiectasis Guideline 2018: a multidisciplinary approach to comprehensive care. Thorax 2019;74. - PubMed
1. Haworth C. BTS Guideline on the management of non-tuberculous mycobacterial pulmonary disease. Thorax 2017;72 (Suppl 2). - PubMed
1. Morice AH, McGarvey L, Pavord I, et al. . Recommendations for the management of cough in adults. Thorax 2006;61(suppl_1):i1–i24. - PMC - PubMed
1. NICE , 2014. Gastro-oesophageal reflux disease and dyspepsia in adults. Available from: https://www.nice.org.uk/guidance/cg184 - PubMed

Grants and funding

MR/L011263/1/MRC_/Medical Research Council/United Kingdom

LinkOut - more resources

Full Text Sources
Medical
- ClinicalTrials.gov

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

British Thoracic Society guideline for bronchiectasis in adults

Affiliations

British Thoracic Society guideline for bronchiectasis in adults

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources

Medical