Lee Eun, Kim Kyunghoon, Jeon You Hoon, Sol In Suk, Kim Jong Deok, Min Taek Ki, Hwang Yoon Ha, Cho Hyun-Ju, Suh Dong In, Kim Hwan Soo, Kim Yoon Hee, Woo Sung-Il, Lee Yong Ju, Jung Sungsu, Yang Hyeon-Jong, Jang Gwang Cheon
Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Clin Exp Pediatr. 2024 Sep;67(9):418-426. doi: 10.3345/cep.2023.00871. Epub 2024 Jan 23.
Noncystic fibrosis bronchiectasis is a chronic respiratory disease that carries high socioeconomic and medical burdens and is caused by diverse respiratory illnesses. To improve clinical outcomes, early recognition, active treatment of exacerbations, and prevention of further exacerbations are essential. However, evidence for the treatment and prevention of acute exacerbation of noncystic fibrosis bronchiectasis, especially in children, is lacking. Therefore, the evidence- and consensus-based guidelines for medical and nonmedical treatment strategies for noncystic fibrosis bronchiectasis in children and adolescents were developed by the Korean Academy of Pediatric Allergy and Respiratory Disease using the methods recommended by the Grading of Recommendations Assessment, Development, and Evaluation working group with evidence published through July 2, 2020. This guideline encompasses evidence-based treatment recommendations as well as expert opinions, addressing crucial aspects of the treatment and management of non-cystic fibrosis bronchiectasis in children. This includes considerations for antibiotics and airway clearance strategies, particularly in areas where evidence may be limited. Large, well-designed, and controlled studies are required to accumulate further evidence of management strategies for noncystic fibrosis bronchiectasis in children and adolescents.
非囊性纤维化支气管扩张症是一种慢性呼吸道疾病,具有较高的社会经济和医疗负担,由多种呼吸道疾病引起。为改善临床结局,早期识别、积极治疗急性加重期以及预防进一步加重至关重要。然而,关于非囊性纤维化支气管扩张症急性加重期的治疗和预防,尤其是儿童患者,证据仍然不足。因此,韩国儿科学会过敏与呼吸疾病学会采用推荐分级评估、制定与评价工作组推荐的方法,依据截至2020年7月2日发表的证据,制定了基于证据和共识的儿童及青少年非囊性纤维化支气管扩张症医疗和非医疗治疗策略指南。本指南涵盖基于证据的治疗建议以及专家意见,涉及儿童非囊性纤维化支气管扩张症治疗和管理的关键方面。这包括对抗生素和气道廓清策略的考量,尤其是在证据可能有限的领域。需要开展大规模、设计良好且有对照的研究,以积累更多关于儿童及青少年非囊性纤维化支气管扩张症管理策略的证据。