Approach to antibiotic therapy for bronchiectasis exacerbations in children with Pseudomonas aeruginosa
Children with bronchiectasis are less likely to have Pseudomonas aeruginosa infection than adults, so the presence of P. aeruginosa in the airways often indicates more advanced disease and is associated with more frequent exacerbations, increased risk of hospitalisation and higher mortalityFinch, 2015.
On the first occasion P. aeruginosa is identified, refer the child to a respiratory physician for eradication therapy.
For children with a bronchiectasis exacerbation who are known to be colonised with P. aeruginosa1, oral therapy is recommended whenever possible. Use intravenous therapy for children who have severe respiratory symptoms (eg increased work of breathing, hypoxaemia) or for those who have not responded to or are unable to tolerate or absorb oral therapyChang, 2021.
Management decisions should be discussed with the treating specialist and guided by the child’s individualised bronchiectasis management plan.