@article{50cf41af57ed404b99b2424c03cbfc93,
title = "Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand. A position statement from the Thoracic Society of Australia and New Zealand and the Australian Lung Foundation",
abstract = "Consensus recommendations for managing chronic suppurative lung disease (CSLD) and bronchiectasis, based on systematic reviews, were developed for Australian and New Zealand children and adults during a multidisciplinary workshop. The diagnosis of bronchiectasis requires a high-resolution computed tomography scan of the chest. People with symptoms of bronchiectasis, but non-diagnostic scans, have CSLD, which may progress to radiological bronchiectasis. CSLD/bronchiectasis is suspected when chronic wet cough persists beyond 8 weeks. Initial assessment requires specialist expertise. Specialist referral is also required for children who have either two or more episodes of chronic (> 4 weeks) wet cough per year that respond to antibiotics, or chest radiographic abnormalities persisting for at least 6 weeks after appropriate therapy. Intensive treatment seeks to improve symptom control, reduce frequency of acute pulmonary exacerbations, preserve lung function, and maintain a good quality of life. Antibiotic selection for acute infective episodes is based on results of lower airway culture, local antibiotic susceptibility patterns, clinical severity and patient tolerance. Patients whose condition does not respond promptly or adequately to oral antibiotics are hospitalised for more intensive treatments, including intravenous antibiotics. Ongoing treatment requires regular and coordinated primary health care and specialist review, including monitoring for complications and comorbidities. Chest physiotherapy and regular exercise should be encouraged, nutrition optimised, environmental pollutants (including tobacco smoke) avoided, and vaccines administered according to national immunisation schedules. Individualised long-term use of oral or nebulised antibiotics, corticosteroids, bronchodilators and mucoactive agents may provide a benefit, but are not recommended routinely. ",
keywords = "amoxicillin, amoxicillin plus clavulanic acid, ampicillin, bromhexine, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, corticosteroid, dicloxacillin, dornase alfa, doxycycline, flucloxacillin, immunoglobulin A, immunoglobulin G, immunoglobulin M, indometacin, influenza vaccine, macrolide, penicillin G, Pneumococcus vaccine, polysaccharide vaccine, ticarcillin, tobramycin, transmembrane conductance regulator, bronchodilating agent, expectorant agent, glucocorticoid, acquired immune deficiency syndrome, acupuncture, anamnesis, antibiotic sensitivity, antibiotic therapy, Australia and New Zealand, awareness, barium enema, blood cell count, bone marrow transplantation, breathing exercise, bronchiectasis, bronchoscopy, chronic obstructive lung disease, chronic supprative lung disease, chronic suppurative lung disease, ciliary dyskinesia, clinical assessment, computer assisted tomography, consensus development, coughing, cystic fibrosis, disease severity, drug tolerance, early diagnosis, echocardiography, environmental exposure, exercise, forced expiratory volume, gene mutation, health education, hospital admission, human, Human immunodeficiency virus infection, immune deficiency, immunoglobulin deficiency, incidence, lung clearance, lung disease, lung fibrosis, lung function, lung transplantation, lung volume, male infertility, medical history, mortality, muscle training, nutritional status, patient assessment, patient monitoring, patient selection, pneumoconiosis, pneumonia, primary health care, pulmonary hypertension, pulmonary rehabilitation, quality of life, review, rheumatoid arthritis, sarcoidosis, serology, sinusitis, smoking, smoking cessation, spirometry, sputum culture, sweat test, thorax radiography, tuberculosis, vaccination, adult, Australia, child, chronic disease, disease course, New Zealand, pathology, public health, suppuration, Adult, Bronchiectasis, Bronchodilator Agents, Child, Chronic Disease, Disease Progression, Expectorants, Glucocorticoids, Humans, Public Health, Suppuration",
author = "Anne Chang and Scott Bell and Byrnes, {Cass A} and Keith Grimwood and Peter Holmes and King, {Paul T} and John Kolbe and Louis Landau and Maguire, {Graeme P} and Malcolm McDonald and Reid, {David W} and Thiens, {Francis C} and Paul Torzillo",
year = "2010",
month = sep,
day = "20",
doi = "10.5694/j.1326-5377.2010.tb03949.x",
language = "English",
volume = "193",
pages = "356--365",
journal = "Medical Journal of Australia",
issn = "0025-729X",
publisher = "Australasian Medical Publishing Company",
number = "6",
}