Published: 6 November 2015
Authors: Byrnes, C.
Presentation to Respiratory Conference New Zealand November 2015.
Bronchiectasis has a significant impact on our New Zealand children. The number affected and the severity of disease are greater here than in other comparable countries. We could improve this with early diagnosis. Children with a chronic wet cough, a cough that recurs frequently, or who produce sputum are highly suspicious for having bronchiectasis; even more so if they have been admitted to hospital at an early age for a respiratory infection.
Intermittent antibiotics and chest physiotherapy are the mainstay of treatment, alongside immunisation, reducing family smoking, exercise and nutrition. However, there is now good evidence for the prolonged use of antibiotics. Medications with success in other respiratory conditions, such as asthma or cystic fibrosis, do not always have the same benefit in bronchiectasis.
It is possible to prevent progression in children, and even see improvement. It is not the irreversible disease seen in adults. If we can diagnose early, follow high-risk children and reduce the time between first concerns and diagnosis (improving referral systems), we could have much better outcomes for the children. We could prevent bronchiectasis altogether.