Management of bronchiectasis and chronic suppurative lung disease in Indigenous children and adults from rural and remote Australian communities

Anne Chang, Keith Grimwood, Graeme P Maguire, Paul T King, Peter Morris, Paul Torzillo

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    � Consensus recommendations for managing bronchiectasis in Indigenous children and adults living in rural and remote regions were developed during a multidisciplinary workshop and were based on available systematic reviews. � Successful diagnosis, management and prevention of bronchiectasis in Indigenous Australians requires access to comprehensive health care services, as well as improved housing, education and employment and reduced poverty levels. � Diagnosis of bronchiectasis requires a chest high-resolution computed tomography scan. Children who have bronchiectasis symptoms but non-diagnostic scans are described as having chronic suppurative lung disease (CSLD), rather than bronchiectasis. Untreated CSLD may progress to bronchiectasis. � Chronic wet cough (> 4 weeks) or recurrent wet cough (> 2 episodes/year) are important but often under-reported symptoms. Bronchiectasis is suspected when chronic cough is excessively prolonged (> 12 weeks) or if a chest radiographic abnormality persists despite appropriate therapy. � Intensive treatment aims to improve symptom control and quality of life while preserving lung function and reducing acute exacerbation frequency. � Antibiotics should be prescribed for acute infective episodes according to culture results of respiratory secretions, local susceptibility patterns and clinical severity. Patients not responding promptly to oral antibiotics should be hospitalised for more intensive treatment. � Ongoing care requires regular primary health care and specialist review, including monitoring for complications and comorbidities. Corticosteroids, bronchodilators and mucoactive agents may be used in individual cases, but routine use is not recommended. Physiotherapy and exercise should be encouraged, nutrition optimised, environmental pollutants (including tobacco smoke) avoided, and immunisations maintained.
    Original languageEnglish
    Pages (from-to)386-393
    Number of pages8
    JournalMedical Journal of Australia
    Volume189
    Issue number7
    Publication statusPublished - 2008

    Fingerprint

    Bronchiectasis
    Lung Diseases
    Cough
    Thorax
    Comprehensive Health Care
    Anti-Bacterial Agents
    Education
    Environmental Pollutants
    Health Services Accessibility
    Bronchodilator Agents
    Poverty
    Smoke
    Health Services
    Tobacco
    Comorbidity
    Immunization
    Primary Health Care
    Adrenal Cortex Hormones
    Therapeutics
    Tomography

    Cite this

    Chang, Anne ; Grimwood, Keith ; Maguire, Graeme P ; King, Paul T ; Morris, Peter ; Torzillo, Paul. / Management of bronchiectasis and chronic suppurative lung disease in Indigenous children and adults from rural and remote Australian communities. In: Medical Journal of Australia. 2008 ; Vol. 189, No. 7. pp. 386-393.
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    Management of bronchiectasis and chronic suppurative lung disease in Indigenous children and adults from rural and remote Australian communities. / Chang, Anne; Grimwood, Keith; Maguire, Graeme P; King, Paul T; Morris, Peter; Torzillo, Paul.

    In: Medical Journal of Australia, Vol. 189, No. 7, 2008, p. 386-393.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Management of bronchiectasis and chronic suppurative lung disease in Indigenous children and adults from rural and remote Australian communities

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    AU - Grimwood, Keith

    AU - Maguire, Graeme P

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    AU - Morris, Peter

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