CHEST releases new adult bronchiectasis management guideline

The American College of Chest Physicians (CHEST) has published a clinical guideline for the management of adult non‑cystic fibrosis bronchiectasis. The guideline, appearing in the journal CHEST, offers 13 conditional, evidence‑based recommendations derived from a systematic review of 47 studies and evaluated with the GRADE approach and a modified Delphi process.

Key recommendations address sputum microbiology‑guided antibiotic therapy, symptom‑based duration of treatment, long‑term macrolide or inhaled antibiotic use, the novel drug brensocatib, airway‑clearance techniques for all patients, and tranexamic acid for hemoptysis. The guideline aims to reduce practice variability, lower exacerbation frequency, and improve quality of life. Lead author Rachel Thomson emphasized shared decision‑making, while investigator Mark Metersky highlighted new aspects such as brensocatib and hemoptysis management.