Figures
- Figure 1
Contributing factors (host, socio-environmental and pathogen) to the development of chronic suppurative lung disease with key features of the pathobiology of bronchiectasis. If the pathways are not interrupted, the resulting airway remodelling eventually becomes irreversible, leading to severe/irreversible bronchiectasis.
- Figure 2
There are many different ACT. In children/adolescents, these are age-specific and best taught by physiotherapists experienced in managing children/adolescents with bronchiectasis. GAD: gravity-assisted drainage; PEP: positive expiratory pressure. Reproduced from the ERS CPG [4] with permission.
- Figure 3
Suggested management approach used by the panel when Pseudomonas aeruginosa is first or newly isolated in a child with bronchiectasis. The suggested approach depends upon: 1) the specimen type, and 2) whether the child is symptomatic. However, panel members acknowledged the approach to initiating eradication treatment is controversial. Some physicians may still feel it is appropriate to initiate eradication therapy based only on a single upper airway specimen, even when symptoms and evidence of benefit in such circumstances are absent. #: if no lower airway specimen available, no treatment if asymptomatic; treat with intravenous anti-pseudomonal antibiotics for 2 weeks if symptomatic. ¶: antibiotic choices are dependent upon patient factors (e.g. adherence, tolerance and preference), availability of antibiotics and P. aeruginosa susceptibility profile. +: although there is no trial evidence, many paediatricians use a combination of two intravenous antibiotics; the recommendation for administering two antibiotics when employing short (2-week) intravenous antibiotic courses is made to align with the studies included in the systematic review and the ERS adult guidelines [23]. Reproduced from the ERS CPG [4] with permission.
