Evaluating current bronchiectasis care in Italy according to the 2025 European respiratory society recommendations.

Abstract

National quality standards for bronchiectasis in Italy were last defined in 2016. The publication of the 2025 European Respiratory Society (ERS) guidelines offers the opportunity to evaluate current clinical practice against updated evidence-based recommendations. To assess the extent to which Italian bronchiectasis centers align with key statements from the 2025 ERS guidelines. National, multicenter, cross-sectional observational study based on a structured survey of Italian bronchiectasis centers, aligned with the 2025 ERS recommendations. A national survey was conducted across Italian bronchiectasis centers affiliated with the Italian Bronchiectasis Patient Association (AIB). The structured questionnaire assessed center organization, diagnostic resources, multidisciplinary care, and alignment with ten predefined core management domains derived from the 2025 ERS recommendations. Most centers reported universal access to minimum bundle etiological tests, with improved capacity compared with 2016. However, specialized diagnostics for rare causes, structured physiotherapy programs, and written self-management plans remain inconsistently available. Long-term inhaled antibiotics and macrolides were widely prescribed, though access barriers persist. Monitoring practices were heterogeneous. Despite clear progress, substantial variability persists in physiotherapy access, rare disease diagnostics, self-management tools, and routine monitoring. Updated Italian quality standards aligned with ERS 2025 principles are warranted. <b>Understanding bronchiectasis care in Italy</b>Bronchiectasis is a chronic lung disease that causes coughing, infections, and mucus build-up. In Italy, national standards for treating this condition had not been reviewed since 2016. This study describes how bronchiectasis is currently managed across Italian hospitals, using data from a recent national survey. Most centers now perform the key tests needed to understand the cause of bronchiectasis and provide the essential treatments recommended by experts. However, more advanced diagnostic tests&#x2014;such as those for rare genetic conditions&#x2014;are not available everywhere. Access to specialist physiotherapy and written self-management plans is also uneven. The way hospitals monitor patients over time varies widely across the country. Overall, care for bronchiectasis in Italy has improved compared with past years, but important differences remain. Updating national standards in line with new European guidelines could help ensure more consistent, high-quality care for all patients.