Bronchiectasis with Increasing Exacerbation Frequency or Severity and Worsening Lung Function

Clinical deterioration in bronchiectasis — marked by more frequent or more severe exacerbations, worsening respiratory symptoms, or accelerating loss of lung function — signals that the current management plan needs comprehensive re-evaluation.

Clinical scenario This protocol applies when a patient with bronchiectasis presents with one or more of the following signs of deterioration:

Increasing exacerbation frequency and/or severity
Worsening of respiratory symptoms
Rapid decline in lung function

Approach overview Management centres on specialist referral and a structured, multi-component review of current treatment using a treatable traits approach — addressing several distinct aspects of care in a targeted way. The complete evidence-based regimen, including specific interventions and sequencing, is available in the full protocol below.

Instant Access to Structured Evidence-Based Regimens

References

Clinical deterioration, including increasing exacerbation frequency and/or severity, worsening of symptoms and/or rapid decline in lung function, should result in a comprehensive re-evaluation of the patients and their treatment.

Deteriorating patients who are not already under the care of a bronchiectasis specialist should be referred to a respiratory clinic with expertise in bronchiectasis.

Current treatment should be reviewed and optimised using a "treatable traits" approach.

DOI: 10.1183/13993003.01126-2025

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