Davies and Wilson listed criteria for identifying a patient with bronchiectasis who may be a candidate for prophylactic antibiotic therapy. The decision to administer prophylactic antibiotics requires consideration of the various benefits and risks entailed. The authors are from the Royal Brompton Hospital in London.


Patient selection: bronchiectasis


Criteria for selecting a patient for prophylactic antibiotic therapy - all of the following:

(1) The diagnosis of bronchiectasis has been established (with appropriate imaging studies).

(2) The patient continues to have significant chronic symptoms despite optimum general management.

(3) Any condition contributing to the bronchiectasis has been identified and treated.

(4) The patient has had 5 or more infective exacerbations requiring antibiotic therapy (oral or parenteral) within the year.


If the Pseudomonas aeruginosa is present, then the patient has not responded to nebulized antibiotic therapy or not tolerated it.


The authors used azithromycin as the prophylactic antibiotic for patients who met all of the selection criteria.


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