Archivos de Bronconeumología Archivos de Bronconeumología
Arch Bronconeumol 2008;44:629-40 - Vol. 44 Núm.11 DOI: 10.1157/13128330
NORMATIVA SEPAR
Diagnóstico y tratamiento de las bronquiectasias
Diagnosis and Treatment of Bronchiectasis
Montserrat Vendrella,, , Javier de Graciab, Casilda Olveirac, Miguel Ángel Martínezd, Rosa Giróne, Luis Máizf, Rafael Cantóng, Ramon Collh, Amparo Escribanoi, Amparo Soléj
a Servicio de Neumología. Hospital Josep Trueta. Girona. España. CIBER Enfermedades Respiratorias (CibeRes)
b Servicio de Neumología. Hospital Universitari Vall d’Hebron. Barcelona. España. CIBER Enfermedades Respiratorias (CibeRes)
c Servicio de Neumología. Hospital Carlos Haya. Málaga. España
d Unidad de Neumología. Hospital General. Requena. Valencia. España
e Servicio de Neumología. Hospital de la Princesa. Madrid. España
f Servicio de Neumología. Hospital Ramón y Cajal. Madrid. España
g Servicio de Microbiología. Hospital Ramón y Cajal. Madrid. España
h Servicio de Rehabilitación. Hospital Germans Trias i Pujol. Badalona. España
i Servicio de Pediatría. Unidad de Neumología Pediátrica. Hospital Clínico Universitario. Universidad de Valencia. España
j Unidad de Fibrosis Quística de Adultos y Trasplante Pulmonar. Hospital Universitario La Fe. Valencia. España
Recibido 06 febrero 2008, Aceptado 11 febrero 2008
Resumen

Bronchiectasis is the end result of several different diseases that share principles of management. The clinical course usually involves chronic bronchial infection and inflammation, which are associated with progression. The cause of bronchiectasis should always be investigated, particularly when it can be treated. We recommend evaluating etiology, symptoms, bronchial colonization and infection, respiratory function, inflammation, structural damage, nutritional status, and quality of life in order to assess severity and to monitor clinical course. Care should be supervised by specialized units, at least in cases of chronic bronchial infection, recurrent exacerbations, or when there is a cause that is likely to respond to treatment. Improving symptoms and halting progression are the goals of management, which is based on treatment of the underlying cause and of acute or chronic infections and on the drainage of secretions. Complications that arise must also be treated. Antibiotic prescription is guided by how well infection is being controlled, and this is indicated by the color of sputum and a reduction in the number of exacerbations. We recommend inhaled antibiotics in cases of chronic bronchial infection that does not respond to oral antibiotics, when these cause side effects, or when the cause is Pseudomonas species or other bacteria resistant to oral antibiotics. Inhaled administration is also advisable to treat initial colonization by Pseudomonas species.

Palabras clave
Bronquiectasias, Agudización, Colonización bronquial, Infección bronquial, Inflamación bronquial
Key words
Bronchiectasis, Exacerbation, Bronchial colonization, Bronchial infection, Bronchial inflammation
Arch Bronconeumol 2008;44:629-40 - Vol. 44 Núm.11 DOI: 10.1157/13128330