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Bronchiectasis with chronic Pseudomonas — SCE Respiratory MCQ

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HardRespiratory InfectionsBronchiectasis with chronic PseudomonasSCE Respiratory

A 63-year-old woman with bronchiectasis has three exacerbations in 12 months. Sputum repeatedly grows Pseudomonas aeruginosa despite airway clearance and vaccinations. FEV1 is 61% predicted and renal function is normal. What is the most appropriate management?

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Correct answer: E — Consider inhaled anti-pseudomonal antibiotic therapy

Frequent exacerbations with chronic Pseudomonas infection despite standard care support consideration of long-term inhaled anti-pseudomonal antibiotics. Oral amoxicillin would not reliably cover Pseudomonas. Steroids and pleurodesis do not address chronic bronchial infection and exacerbation prevention.

Reference: BTS Bronchiectasis Guideline 2019