title: Challenges in managing Pseudomonas aeruginosa in non-cystic fibrosis bronchiectasis.
abstract: An Expert Forum was held at the 2014 European Respiratory Society International Congress to address issues involved in the management of Pseudomonas aeruginosa infection in patients with non-cystic fibrosis bronchiectasis (NCFB). Multiple studies have found that chronic P. aeruginosa infection is associated with more severe disease and higher morbidity and mortality.
  
  
  
  Participants discussed appropriate management of P. aeruginosa infection at three stages: 1) first isolation, including eradication protocols; 2) during exacerbations; and 3) during chronic infection, including long-term antibiotic therapy to reduce the severity of symptoms and frequency of exacerbations. Topics covered included frequency of sputum cultures, antibiotic treatment at first isolation and for exacerbations, optimal use of inhaled antibiotics, indications for long-term therapy, and treatment regimens that may reduce the frequency or severity of symptoms. Electronic polling and roundtable discussions followed by expert insights were used to address these topics. Significant diversity in management practices was reported among different countries and centres, and in many cases clinical management was at variance with published guidelines.
  
  
  
  This Expert Forum identified standardised terminology, clinician training, additional research into management strategies, and the development of new drugs as areas requiring improvement for the optimal management of P. aeruginosa in NCFB.
authors: Host Defence Unit, Royal Brompton Hospital, London, UK. Electronic address: r.wilson@rbht.nhs.uk.
authors: Robert
authors: R
authors: Wilson
authors: Mayo Clinic, Pulmonary Disease and Critical Care Medicine, Rochester, MN, USA.
authors: Timothy
authors: T
authors: Aksamit
authors: Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors: Stefano
authors: S
authors: Aliberti
authors: Newcastle University and Freeman Hospital, Newcastle Upon Tyne, UK.
authors: Anthony
authors: A
authors: De Soyza
authors: Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK.
authors: J Stuart
authors: JS
authors: Elborn
authors: University Hospital of Gasthuisberg, Department of Respiratory Disease, Leuven, Belgium; Department of Respiratory Disease, AZ Nikolaas, St-Nikolaas, Belgium.
authors: Pieter
authors: P
authors: Goeminne
authors: Department of Respiratory Medicine Royal Infirmary of Edinburgh and the University of Edinburgh, Edinburgh, UK.
authors: Adam T
authors: AT
authors: Hill
authors: Pneumology Department, Hospital Universitario y politecnico La Fe, CIBERES, Valencia, Spain.
authors: Rosario
authors: R
authors: Menendez
authors: Fundaciò Clinic, IDIBAPS, CIBERES, Hospital Clinic de Barcelona, Barcelona, Spain.
authors: Eva
authors: E
authors: Polverino
mesh_terms: D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001987:Bronchiectasis / Q000188:drug therapy*; D003550:Cystic Fibrosis / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology; D019468:Disease Management; D018450:Disease Progression; D006801:Humans; D017410:Practice Guidelines as Topic; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000401:mortality; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D012137:Respiratory System / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Airway inflammation; Antibiotics; Clinical management; Lower airway infection; Non-CF bronchiectasis; Pseudomonas aeruginosa