Quality standards for the management of bronchiectasis in Italy: a national audit

Summary of the quality statements for bronchiectasis in adults and percentage adherence in the Italian Society of Respiratory Medicine (SIP) Audit. ^#: people with a clinical diagnosis of bronchiectasis have the diagnosis confirmed by chest computed tomography (CT) scan (using 1 mm slices). ^¶: people with bronchiectasis to be investigated for allergic bronchopulmonary aspergillosis, common variable immunodeficiency and cystic fibrosis (the last of these, if indicated), as these are specific treatable causes. ⁺: people with bronchiectasis have sputum bacteriology culture when clinically stable recorded at least once each year. ^§: sputum is sent for bacterial culture at the start of an exacerbation before starting antibiotics; empirical antibiotic treatment to start as soon as feasible and not await the sputum culture results. ^ƒ: people with bronchiectasis are taught appropriate airway clearance techniques by a specialist respiratory physiotherapist and advised of the frequency and duration with which these should be carried out. ^##: people with bronchiectasis to attend pulmonary rehabilitation if they have breathlessness affecting their activities of daily living. ^¶¶: services for people with bronchiectasis to include provision of nebulised prophylactic antibiotic therapy (ABT) for suitable patients supervised by a respiratory specialist. ⁺⁺: people with bronchiectasis to have an individualised, written self-management plan. ^§§: people with bronchiectasis who meet the criteria for continuing secondary care to be managed by a multidisciplinary team led by a respiratory physician. ^ƒƒ: services for people with bronchiectasis to include provision of home intravenous ABT for exacerbations in selected patients.