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Bronchiectasis with chronic Pseudomonas infection — SCE Respiratory MCQ

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HardRespiratory infectionsBronchiectasis with chronic Pseudomonas infectionSCE Respiratory

A 66-year-old woman with bronchiectasis has daily purulent sputum and four exacerbations in a year. HRCT shows bilateral cylindrical bronchiectasis and sputum cultures repeatedly grow Pseudomonas aeruginosa. She has completed airway clearance training and uses nebulised saline. Renal function and hearing are normal. What is the most appropriate management?

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Correct answer: C — Long-term nebulised antipseudomonal antibiotic after specialist review

Chronic Pseudomonas infection with frequent exacerbations despite airway clearance supports specialist consideration of inhaled antipseudomonal antibiotics. Oral amoxicillin does not cover Pseudomonas and would be poorly targeted. Bronchiectasis management is built around airway clearance, microbiology and exacerbation frequency.

Reference: BTS Bronchiectasis Guideline 2019: https://www.nice.org.uk/guidance/ng245/chapter/recommendations