Chronic suppurative lung disease (CSLD) and bronchiectasis in children

Summary of changes

Medicines

  • Antibiotics for acute episode
  • If allergic to penicillin cefuroxime replaces cefaclor (cefuroxime is more effective against haemophilus influenza and strep pneumoniae)
  • Azithromycin removed as alternative - not needed, not in guidelines and increasing macrolide resistance

Other

  • Defined days (3) of increased cough for diagnosing exacerbation 

Primary references

  1. Chang AB, Bell SC, Torzillo PJ, King PT, Maguire GP, Byrnes CA, Holland AE, O'Mara P and Grimwood K (2015) 'Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand Thoracic Society of Australia and New Zealand guidelines', Medical Journal of Australia, 202(3):130, doi:10.5694/mjac14.00287

  2. Chang AB, Bush A and Grimwood K (2018) 'Bronchiectasis in children: diagnosis and treatment', The Lancet, 392(10150):866-879, doi:10.1016/S0140-6736(18)31554-X

  3. Chang AB, Fortescue R, Grimwood K, Alexopoulou E, Bell L, Boyd J, Bush A, Chalmers JD, Hill AT, Karadag B, Midulla F, McCallum GB, Powell Z, Snijders D, Song WJ, Tonia T, Wilson C, Zacharasiewicz A and Kantar A (2021) 'Task Force report: European Respiratory Society guidelines for the management of children and adolescents with bronchiectasis', European Respiratory Journal, 58(2):2002990, doi:10.1183/13993003.02990-2020

  4. Goyal V, Grimwood K, Byrnes CA, Morris PS, Masters IB, Ware RS, McCallum GB, Binks MJ, Marchant JM, van Asperen P, O'Grady KF, Champion A, Buntain HM, Petsky H, Torzillo PJ and Chang AB (2018) 'Amoxicillin-clavulanate versus azithromycin for respiratory exacerbations in children with bronchiectasis (BEST-2): a multicentre, double-blind, non-inferiority, randomised controlled trial', The Lancet, 392(10154):1197-1206, doi:10.1016/S0140-6736(18)31723-9

  5. McCallum GB and Binks MJ (2017) 'The Epidemiology of Chronic Suppurative Lung Disease and Bronchiectasis in Children and Adolescents', Frontiers in Pediatrics, 5:27, doi:10.3389/fped.2017.00027

Indigenous/remote context references

  1. McCallum GB, Singleton RJ, Redding GJ, Grimwood K, Byrnes CA, Valery PC, Mobberley C, Oguoma VM, Eg KP, Morris PS and Chang AB (2020) 'A decade on: Follow-up findings of indigenous children with bronchiectasis', Pediatric Pulmonology, 55(4):975-985, doi:10.1002/ppul.24696

  2. Valery PC, Morris PS, Byrnes CA, Grimwood K, Torzillo PJ, Bauert PA, Masters IB, Diaz A, McCallum GB, Mobberley C, Tjhung I, Hare KM, Ware RS and Chang AB (2013) 'Long-term azithromycin for Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (Bronchiectasis Intervention Study): a multicentre, double-blind, randomised controlled trial', The Lancet Respiratory Medicine, 1(8):610-620, doi:10.1016/S2213-2600(13)70185-1