The incidence of bronchiectasis in Wales is increasing, and improving the management of exacerbations for these patients will have a big impact on their quality of life and mortality.
The right place for many patients experiencing an exacerbation of their bronchiectasis is at home; they are much safer and can be equipped to receive intravenous antibiotics at home.
An initiative in Wales to standardise the approach of managing these patients, ideally in the community, comes in the form of the All-Wales Pathway for Managing Adult non-CF Bronchiectasis Patients with Pseudomonas Aeruginosa Infection in the Community.
- Confirm the presence of bronchiectasis using a high resolution CT, and the presence of Pseudomonas aeruginosa in sputum in patients with confirmed Bronchiectasis.
- Assess the patient for clinical deterioration and, if they are having an exacerbation, determine whether they can be safely managed at home or do they need admitting to hospital.
- Optimise the patient's condition in the community, and treat using first line and second line antibiotics.
- Initiate longterm antipseudomonal nebulised antibiotics to reduce the risk of future exacerbations.