In bronchiectasis follow-up, ask two separate questions: how many courses of antibiotics for a chest flare in the past year, and how many of those needed a hospital admission. A single admission predicts further admissions strongly, so it should trigger the same review as multiple outpatient flares — sputum culture including mycobacteria, a check of airway clearance technique with a physiotherapist, vaccination status, and a decision on long-term prophylaxis. Write both numbers at the top of the clinic letter so the next clinician sees the trend.
- Ask how many antibiotic courses for chest flares in the past year.
- Ask separately how many needed admission.
- After any admission, send sputum for bacterial and mycobacterial culture.
- Record both numbers prominently in the clinic letter.
Why it matters
A hospitalised exacerbation is the strongest single predictor of the next one.
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