Recommendations of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
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
Corresponding author
mvendrell.girona.ics@gencat.cat
Correspondence: Dra M. Vendrell P.o Canalejas 1, esc. 3, 3.o 1.a 17001 Girona, Spain
Correspondence: Dra M. Vendrell P.o Canalejas 1, esc. 3, 3.o 1.a 17001 Girona, Spain
a Servicio de Neumología, Hospital Josep Trueta, Girona, Spain, CIBER Enfermedades Respiratorias (CibeRes)
b Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain, CIBER Enfermedades Respiratorias (CibeRes)
c Servicio de Neumología, Hospital Carlos Haya, Málaga, Spain
d Unidad de Neumología, Hospital General, Requena, Valencia Spain
e Servicio de Neumología, Hospital de la Princesa, Madrid, Spain
f Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain
g Servicio de Microbiología, Hospital Ramón y Cajal, Madrid, Spain
h Servicio de Rehabilitación, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
i Servicio de Pediatría, Unidad de Neumología Pediátrica, Hospital Clínico Universitario, Universidad de Valencia, Spain
j Unidad de Fibrosis Quística de Adultos y Trasplante Pulmonar, Hospital Universitario La Fe, Valencia, Spain
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class="elsevierStyleSup">h</span>" "identificador" => "aff8" ] 8 => array:3 [ "entidad" => "Servicio de Pediatría, Unidad de Neumología Pediátrica, Hospital Clínico Universitario, Universidad de Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">i</span>" "identificador" => "aff9" ] 9 => array:3 [ "entidad" => "Unidad de Fibrosis Quística de Adultos y Trasplante Pulmonar, Hospital Universitario La Fe, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">j</span>" "identificador" => "aff10" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra M. Vendrell P.<span class="elsevierStyleSup">o</span> Canalejas 1, esc. 3, 3.<span class="elsevierStyleSup">o</span> 1.<span class="elsevierStyleSup">a</span> 17001 Girona, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-02-06" "fechaAceptado" => "2008-11-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155097" "palabras" => array:5 [ 0 => "Bronchiectasis" 1 => "Exacerbation" 2 => "Bronchial colonization" 3 => "Bronchial infection" 4 => "Bronchial inflammation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155096" "palabras" => array:5 [ 0 => "Bronquiectasias" 1 => "Agudización" 2 => "Colonización bronquial" 3 => "Infección bronquial" 4 => "Inflamación bronquial" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">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 when there is a history of chronic bronchial infection, recurrent exacerbations, or 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 monitoring 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 when bronchial infection is chronic and does not respond to oral antibiotics or when these cause side effects, or when the cause is <span class="elsevierStyleItalic">Pseudomonas</span> species or other bacteria resistant to oral antibiotics. Inhaled administration is also advisable to treat initial colonization by <span class="elsevierStyleItalic">Pseudomonas</span> species.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Las bronquiectasias son el resultado final de enfermedades diferentes que tienen puntos de manejo comunes. Suelen cursar con infección e inflamación bronquiales crónicas que se asocian con progresión. Siempre debe investigarse la etiología, en especial de las tributarias de tratamiento. Para valorar la gravedad y hacer el seguimiento, recomendamos evaluar la etiología, la clínica, la colonización-infección bronquial, la función respiratoria, la inflamación, el daño estructural, el estado nutricional y la calidad de vida. Su atención debería realizarse en unidades especializadas, al menos en casos de infección bronquial crónica, agudizaciones repetidas o etiología susceptible de tratamiento. El tratamiento tiene como objetivo mejorar la clínica y detener la progresión, y se basa en el tratamiento de la etiología, de la infección aguda y crónica, en el drenaje de secreciones y en el tratamiento de las complicaciones. La pauta de administración del antibiótico depende del control de la infección, que se comprueba con el color del esputo y la disminución de las agudizaciones. Recomendamos los antibióticos inhalados en la infección bronquial crónica sin respuesta clínica o con efectos secundarios al antibiótico oral, en la causada por <span class="elsevierStyleItalic">Pseudomonas,</span> en la causada por microorganismos resistentes a los antibióticos orales y en la colonización inicial por <span class="elsevierStyleItalic">Pseudomonas.</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:51 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cystic fibrosis pulmonary guidelines. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 2 | 4 |
| 2024 October | 45 | 31 | 76 |
| 2024 September | 37 | 29 | 66 |
| 2024 August | 57 | 42 | 99 |
| 2024 July | 35 | 26 | 61 |
| 2024 June | 41 | 39 | 80 |
| 2024 May | 52 | 50 | 102 |
| 2024 April | 42 | 30 | 72 |
| 2024 March | 45 | 27 | 72 |
| 2024 February | 23 | 30 | 53 |
| 2023 March | 2 | 3 | 5 |
| 2023 February | 19 | 27 | 46 |
| 2023 January | 21 | 43 | 64 |
| 2022 December | 21 | 43 | 64 |
| 2022 November | 28 | 44 | 72 |
| 2022 October | 23 | 35 | 58 |
| 2022 September | 25 | 24 | 49 |
| 2022 August | 24 | 50 | 74 |
| 2022 July | 24 | 44 | 68 |
| 2022 June | 22 | 45 | 67 |
| 2022 May | 22 | 43 | 65 |
| 2022 April | 24 | 44 | 68 |
| 2022 March | 23 | 43 | 66 |
| 2022 February | 19 | 32 | 51 |
| 2022 January | 20 | 36 | 56 |
| 2021 December | 21 | 57 | 78 |
| 2021 November | 28 | 52 | 80 |
| 2021 October | 69 | 62 | 131 |
| 2021 September | 53 | 75 | 128 |
| 2021 August | 23 | 38 | 61 |
| 2021 July | 21 | 42 | 63 |
| 2021 June | 35 | 38 | 73 |
| 2021 May | 22 | 48 | 70 |
| 2021 April | 35 | 65 | 100 |
| 2021 March | 22 | 43 | 65 |
| 2021 February | 19 | 35 | 54 |
| 2021 January | 22 | 28 | 50 |
| 2020 December | 10 | 28 | 38 |
| 2020 November | 11 | 34 | 45 |
| 2020 October | 10 | 22 | 32 |
| 2020 September | 5 | 26 | 31 |
| 2020 August | 11 | 18 | 29 |
| 2020 July | 10 | 38 | 48 |
| 2020 June | 7 | 7 | 14 |
| 2020 May | 12 | 26 | 38 |
| 2020 April | 16 | 35 | 51 |
| 2020 March | 14 | 18 | 32 |
| 2020 February | 11 | 13 | 24 |
| 2020 January | 20 | 30 | 50 |
| 2019 December | 28 | 31 | 59 |
| 2019 November | 11 | 23 | 34 |
| 2019 October | 6 | 23 | 29 |
| 2019 September | 8 | 17 | 25 |
| 2019 August | 12 | 26 | 38 |
| 2019 July | 12 | 31 | 43 |
| 2019 June | 12 | 15 | 27 |
| 2019 May | 14 | 39 | 53 |
| 2019 April | 28 | 35 | 63 |
| 2019 March | 20 | 43 | 63 |
| 2019 February | 16 | 34 | 50 |
| 2019 January | 15 | 29 | 44 |
| 2018 December | 12 | 38 | 50 |
| 2018 November | 16 | 63 | 79 |
| 2018 October | 9 | 64 | 73 |
| 2018 September | 14 | 85 | 99 |
| 2018 April | 7 | 7 | 14 |
| 2018 March | 4 | 7 | 11 |
| 2018 February | 6 | 10 | 16 |
| 2018 January | 3 | 9 | 12 |
| 2017 December | 7 | 44 | 51 |
| 2017 November | 3 | 103 | 106 |
| 2017 October | 4 | 131 | 135 |
| 2017 September | 12 | 109 | 121 |
| 2017 August | 6 | 88 | 94 |
| 2017 July | 3 | 102 | 105 |
| 2017 June | 12 | 120 | 132 |
| 2017 May | 6 | 156 | 162 |
| 2017 April | 7 | 68 | 75 |
| 2017 March | 4 | 126 | 130 |
| 2017 February | 3 | 55 | 58 |
| 2017 January | 3 | 22 | 25 |
| 2016 December | 7 | 26 | 33 |
| 2016 November | 14 | 22 | 36 |
| 2016 October | 14 | 25 | 39 |
| 2016 September | 21 | 20 | 41 |
| 2016 August | 13 | 7 | 20 |
| 2016 July | 6 | 0 | 6 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 268 | 181 | 449 |
| 2015 September | 221 | 165 | 386 |
| 2015 August | 247 | 125 | 372 |
| 2015 July | 307 | 127 | 434 |
| 2015 June | 217 | 108 | 325 |
| 2015 May | 300 | 154 | 454 |
| 2015 April | 275 | 161 | 436 |
| 2015 March | 328 | 130 | 458 |
| 2015 February | 292 | 96 | 388 |
| 2015 January | 114 | 98 | 212 |
| 2014 December | 100 | 104 | 204 |
| 2014 November | 104 | 130 | 234 |
| 2014 October | 129 | 153 | 282 |
| 2014 September | 109 | 123 | 232 |
| 2014 August | 101 | 93 | 194 |
| 2014 July | 84 | 115 | 199 |
| 2014 June | 126 | 108 | 234 |
| 2014 May | 120 | 119 | 239 |
| 2014 April | 104 | 140 | 244 |
| 2014 March | 111 | 126 | 237 |
| 2014 February | 119 | 80 | 199 |
| 2014 January | 86 | 66 | 152 |
| 2013 December | 89 | 46 | 135 |
| 2013 November | 83 | 33 | 116 |
| 2013 October | 96 | 56 | 152 |
| 2013 September | 93 | 50 | 143 |
| 2013 August | 94 | 27 | 121 |
| 2013 July | 95 | 40 | 135 |
| 2013 June | 78 | 22 | 100 |
| 2013 May | 81 | 16 | 97 |
| 2013 April | 60 | 14 | 74 |
| 2013 March | 13 | 4 | 17 |
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