Pediatric Bronchiectasis Guidelines

Updated: Dec 16, 2022
  • Author: Kristen N Miller, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Guidelines Summary

European Respiratory Society guidelines

The European Respiratory Society (ERS) released guidelines for the management of bronchiectasis in children and adolescents. [28] Highlights of the guidelines include the following:

  • The ERS suggests that multidetector chest computed tomography scans with high-resolution CT (HRCT) be used to diagnose bronchiectasis in pediatric patients rather than conventional HRCT.
  • The suggested CT criterion for abnormal broncho-arterial dilatation in children and adolescents is >0.8 instead of the adult cut-off of >1-1.5.
  • In pediatric patients with bronchiectasis, the ERS advises against the routine use of inhaled corticosteroids either alone or coupled with long-acting β2-agonists. Inhaled corticosteroids may be of benefit in patients who have eosinophilic airway inflammation.
  • The ERS recommends against the use of recombinant human DNase and bromhexine in children and adolescents with bronchiectasis. Neither inhaled mannitol nor hypertonic saline should be used routinely.
  • Children and adolescents should be taught airway clearance techniques (ACT) and receive airway clearance regularly. During acute exacerbations of bronchiectasis, ACT should be performed more frequently.
  • The ERS recommends a 14-day course of antibiotic therapy for an acute respiratory exacerbation of bronchiectasis in children and adolescents.
  • Following an initial or new detection of Pseudomonas aeruginosa, the ERS suggests eradication therapy in pediatric patients with bronchiectasis.
  • For children and adolescents who have recurrent exacerbations of bronchiectasis, the ERS recommends long-term therapy with macrolide antibiotics.