Further clinical guidance can be found at:
CKS – Bronchiectasis: Infective Exacerbation
BTS Guideline - Non CF Bronchiectasis
First choice empirical antibiotics:
Amoxicillin
500mg TDS
7-14 Days
or Clarithromycin
(do not use if on long-term azithromycin already)
500mg BD
7-14 Days
or Doxycycline
200mg on Day 1 then 100mg OD
7-14 days
Pseudomonas colonisation:
First choice empirical antibiotic (as above)
7-14 days
Pseudomonas colonisation and clinical failure on first choice antibiotic:
Ciprofloxacin
750mg BD
7-14 days
Other organisms (e.g. Haemophilus influenzae, Staph aureus):
Refer to CKS Bronchiectasis Scenario: Infective exacerbation Table 1
or discuss with consultant microbiologist.
Treatment indicated if there are signs of infection e.g.
Sputum culture essential to identify causative organism and monitor antibiotic resistance.
Initial treatment following sputum culture: previous cultures and sensitivities should guide antibiotic choice.
Consider bronchodilators and ensure expectoration techniques are being carried out. Home antibiotic therapy (IV or nebulised) or long term azithromycin therapy should only be commenced after consultation with Respiratory Physician.
If clinical failure despite two courses of different classes of antibiotic - discuss with Respiratory team.