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Chronic Pseudomonas bronchiectasis — SCE Respiratory MCQ

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ModerateRespiratory InfectionsChronic Pseudomonas bronchiectasisSCE Respiratory

A 62-year-old woman with long-standing bronchiectasis has daily sputum, three exacerbations in the past year and chronic Pseudomonas aeruginosa in sputum. She has optimised airway clearance and no NTM on cultures. What is the most appropriate management?

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Correct answer: B — Consider long-term inhaled anti-pseudomonal antibiotic therapy

Frequent exacerbations with chronic Pseudomonas despite airway clearance supports consideration of long-term inhaled anti-pseudomonal antibiotics. Prednisolone is not standard bronchiectasis maintenance therapy and can increase infection risk. Empirical amoxicillin may miss Pseudomonas, while antifibrotics and stopping airway clearance are inappropriate.

Reference: BTS Bronchiectasis Guideline 2019