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Bronchiectasis exacerbation prevention — SCE Respiratory MCQ

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EasyRespiratory InfectionsBronchiectasis exacerbation preventionSCE Respiratory

A 57-year-old woman with bronchiectasis has four infective exacerbations in 12 months despite airway clearance and vaccination. Sputum repeatedly grows Haemophilus influenzae, QTc is normal and hearing screen is acceptable. What is the most appropriate management?

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Correct answer: C — Consider long-term macrolide prophylaxis after excluding NTM

Frequent bronchiectasis exacerbations despite optimisation are an indication to consider long-term macrolide prophylaxis after excluding NTM infection. Ciprofloxacin monotherapy is not preferred for long-term prophylaxis because of resistance and toxicity. Oral prednisolone and inhaled antifungal therapy do not address recurrent bacterial exacerbations.

Reference: BTS Guideline for Bronchiectasis in Adults 2018; BNF