European Respiratory Society clinical practice guideline for the management of adult bronchiectasis.

Exacerbations and daily symptoms have the largest impact on patients and healthcare systems, and they are the key focus of treatments.

加重和日常症状对患者和医疗系统的影响最大，它们是治疗的主要焦点。

Current practice is heterogeneous globally, and bronchiectasis has historically been a neglected disease.

目前全球的实践做法存在差异，支气管扩张症历史上一直是一种被忽视的疾病。

Here, we present evidence-based international guidelines for the management of adults with bronchiectasis.

在这里，我们提出了针对成人支气管扩张症管理的循证国际指南。

Methods

A European Respiratory Society (ERS) Task Force, comprising global experts, a methodologist and patient representatives, developed clinical practice guidelines in accordance with ERS methodology and the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach.

由全球专家、方法学家和患者代表组成的欧洲呼吸学会（ERS）特别工作组，根据ERS的方法论和GRADE（推荐、评估、发展和评估的分级）方法，制定了临床实践指南。

Systematic literature searches, data extraction and meta-analysiswere performed to generate evidence tables, and recommendations were formulated using the evidence-to-decision framework.

通过系统性的文献搜索、数据提取和荟萃分析生成了证据表，并使用证据到决策框架制定了推荐意见。

A total of eight PICO (Patients, Intervention, Comparator, Outcomes) questions and three narrative questions were developed.

共开发了八个PICO（患者、干预、比较、结果）问题和三个叙述性问题。

recommendations

The Task Force recommendations include strong recommendations in favour of airway clearance techniques for most patients with bronchiectasis, and pulmonary rehabilitation for those with impaired exercise capacity.

任务组的建议包括强烈推荐大多数支气管扩张症患者使用气道清除技术，以及对于运动能力受损的患者推荐肺康复治疗。

We issue a strong recommendation for the use of long-term macrolide treatment for patients at high risk of exacerbations and a strong recommendation in favour of long-term inhaled antibiotics in patients with chronic Pseudomonas aeruginosa infection at high risk of exacerbation.

我们强烈推荐对于高风险加重的患者使用长期大环内酯类治疗，以及对于慢性铜绿假单胞菌感染且高风险加重的患者强烈推荐长期吸入性抗生素治疗。

Conditional recommendations support the use of eradication treatment or mucoactive drugs in specific circumstances.

在特定情况下，条件性推荐支持使用根除治疗或粘液活性药物。

We suggest not to routinely use long-term oral, non-macrolide antibiotic treatment or inhaled corticosteroids.

我们建议不要常规使用长期口服非大环内酯类抗生素治疗或吸入性皮质类固醇。

Additional guidance is also provided on testing for underlying causes, managing exacerbations and managing the deteriorating patient.

还提供了关于检测潜在原因、管理加重期和处理病情恶化的额外指导。

Conclusions

The ERS bronchiectasis guidelines provide an evidence-based framework for optimal management of adults with bronchiectasis and serve as a benchmark for evaluating the quality of care.

ERS支气管扩张症指南为成人支气管扩张症的最佳管理提供了基于证据的框架，并作为评估护理质量的基准。