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Bronchiectasis with Pseudomonas — SCE Respiratory MCQ

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ModerateRespiratory InfectionsBronchiectasis with PseudomonasSCE Respiratory

A 61-year-old man with bronchiectasis has his first sputum isolate of Pseudomonas aeruginosa during an exacerbation. CT confirms cylindrical bronchiectasis and he has had three exacerbations in the past year. What is the most appropriate management after treating the acute exacerbation?

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Correct answer: D — Attempt Pseudomonas eradication with specialist-directed antibiotic regimen

First isolation of Pseudomonas in bronchiectasis should prompt consideration of eradication because chronic colonisation is associated with worse outcomes. Ignoring the isolate may miss a window to prevent chronic infection. Corticosteroids, stopping airway clearance and lobectomy are not appropriate first responses.

Reference: BTS Guideline for Bronchiectasis in Adults 2018