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Bronchiectasis with first Pseudomonas isolation — SCE Respiratory MCQ

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ModerateRespiratory InfectionsBronchiectasis with first Pseudomonas isolationSCE Respiratory

A 57-year-old man with bronchiectasis has his first sputum culture positive for Pseudomonas aeruginosa. He has increased sputum but is clinically stable and has not previously grown Pseudomonas. CT confirms cylindrical bronchiectasis without cavitation. What is the most appropriate management?

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Correct answer: C — Attempt Pseudomonas eradication with appropriate oral or intravenous therapy plus inhaled antibiotic strategy

First isolation of Pseudomonas in bronchiectasis should prompt an eradication attempt because chronic infection worsens outcomes. Waiting for chronic colonisation misses a treatment window, and corticosteroids do not eradicate bacteria. TB drugs are irrelevant and airway clearance remains a key part of bronchiectasis care.

Reference: BTS Bronchiectasis Guideline 2019