New guideline provides 13 recommendations for adult bronchiectasis management.
Management of Adult Bronchiectasis: An American College of Chest Physicians Clinical Practice Guideline.
Rachel Thomson et al. · Chest · 2026
Background
Bronchiectasis is a chronic respiratory condition involving a cycle of impaired mucociliary clearance, chronic infections, inflammation, and progressive airway destruction, leading to persistent cough with sputum production, dyspnea, and fatigue.
Purpose
Bronchiectasis research should aim to address many of the uncertainties in management, and priorities are identified within each PICO question.
Methods
An expert panel developed eight PICO-based questions addressing treatment of bronchiectasis in adults and conducted a systematic review.
n = 47 studies
Results
total guidance points for managing a chronic lung condition
n = 47 studies
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Conclusion · 1 of 3
All recommendations are conditional, primarily based on low-certainty evidence. Bronchiectasis research should aim to address many of the uncertainties in management, and priorities are identified within each PICO question.
Conclusion · 2 of 3
Accurate phenotyping and endotyping may help guide therapeutic decision-making and risk stratification. Treatment interventions must consider potential treatment burdens, including cost, and impact on quality of life.
Conclusion · 3 of 3
Finally, shared decision-making with patients utilizing a multidisciplinary approach is paramount.