Diagnosis of bronchiectasis has increased with broader availability of high-resolution CT scanning. Early diagnosis and development of a patient-specific exercise and airway clearance regimen and a pathogen eradication and suppression plan are key to successful treatment. Management can be shared by GPs in co-operation with a specialist respiratory physician and respiratory physiotherapist.
- Underdiagnosis of bronchiectasis has been a significant problem caused in part by clouding by coexisting respiratory comorbidities including chronic obstructive pulmonary disease and asthma.
- High-resolution CT scanning is now widely available and is the gold standard diagnostic test.
- Confirming a diagnosis of bronchiectasis enables the provision of disease-appropriate treatments and the rationalisation of potentially inappropriate treatments.
- Exercise, airway clearance and mucoactive therapies all help reduce airway inflammatory burden, leading to reduced symptoms and exacerbations and improved quality of life.
- Microbiological surveillance enables the identification of agents such as Pseudomonas aeruginosa and nontuberculous mycobacteria that have powerful negative impacts on symptoms, lung function, exacerbations and healthcare utilisation.
- Antibiotics play a key role in the eradication of novel microbial isolates, immunomodulation, exacerbation management and long-term suppression of microbial colonisation in the airways.
- GPs can share in tailoring a patient-specific management plan in co-operation with a specialist respiratory physician and respiratory physiotherapist.