Check for updatesRecetved:13 October 2022Accepted:18 January 2023D0L10.1111/rep.14479POSITION PAPERRespirologyCWILEYThoracic Society of Australia and New Zealand(TSANZ)positionstatement on chronic suppurative lung disease and bronchiectasisin children,adolescents and adults in Australia and New ZealandAnne B.Chang123 Scott C.Bell5.6 Catherine A.Byrnes7Paul Dawkins10 Anne E.Holland111213 Emma Kennedy1415,16Paul T.King17 Pamela Laird 1819,20 Sarah Mooney21 Lucy Morgan22Marianne Parsons23 Betty Poot2425 Maree Toombs26 Paul J.Torzillo27.28Keith Grimwood29,30CorrespondenceAbstractAnne B.ChangEmail anne .chang@cdu.edu.auThis position statement,updated from the 2015 guidelines for managing Australianand New Zealand children/adolescents and adults with chronic suppurative lung dis-Funding informationease (CSLD)and bronchiectasis,resulted from systematic literature searches by aNational Health and Medical Research Council,multi-disciplinary team that included consumers.The main statements are:Grant/Award Numbers:1170958,1154302;Children's Hospital FoundationDiagnose CSLD and bronchiectasis early;this requires awareness of bronchiectasissymptoms and its co-existence with other respiratory diseases (e.g,asthma,Handling Editor:Paul Reynoldschronic obstructive pulmonary disease).Confirm bronchiectasis with a chest computed-tomography scan,using age-appropriate protocols and criteria in children.Undertake a baseline panel of investigations.Assess baseline severity,and health impact,and develop individualized manage-ment plans that include a multi-disciplinary approach and coordinated carebetween healthcare providers.Employ intensive treatment to improve symptom control,reduce exacerbationfrequency,preserve lung function,optimize quality-of-life and enhance survival.In children,treatment also aims to optimize lung growth and,when possible,reverse bronchiectasis.Individualize airway clearance techniques (ACTs)taught by respiratory physio-therapists,encourage regular exercise,optimize nutrition,avoid air pollutants andadminister vaccines following national schedules.Treat exacerbations with 14-day antibiotic courses based upon lower airway cul-ture results,local antibiotic susceptibility patterns,clinical severity and patient tol-erance.Patients with severe exacerbations and/or not responding to outpatienttherapy are hospitalized for further treatments,including intravenous antibioticsand intensive ACTs.Eradicate Pseudomonas aeruginosa when newly detected in lower airway cultures.This document has been endorsed by the Thoracic Society of Australia and NewZealand on 15 February 2023.For affiliations refer to page9This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License,which permits use,dist ribution and reproduction in any medium.provided the original work is properly cited and is not used for commercial purposes.2023 The Authors.Respirology published by John Wiley Sons Australia,Ltd on behalf of Asian Pacific Socie
