[Highlights and interpretation of the 2025 European Respiratory Society clinical practice guideline for the management of adult bronchiectasis].

In 2025, the European Respiratory Society (ERS) released the latest Clinical Practice Guideline for the Management of Adult Bronchiectasis. This guideline addressed eight PICO (Population, Intervention, Comparison, Outcome) questions and three narrative questions. The guideline strongly recommends airway clearance techniques for most patients, as well as pulmonary rehabilitation for those experiencing dyspnea or impaired exercise capacity. Long-term macrolide therapy is strongly recommended for patients at high risk of exacerbations, and long-term inhaled antibiotics are strongly advised for patients with chronic Pseudomonas aeruginosa infection and frequent exacerbations. Eradication therapy and the use of mucoactive agents are conditionally recommended in certain cases. Routine long-term use of non-macrolide oral antibiotics or inhaled corticosteroids is not recommended. In addition, the guideline provides updated recommendations on etiological evaluation, acute exacerbation management, and the care of patients with disease progression. This article aims to systematically interpret the core updates of the new ERS guideline, compare them with previous versions, and offer insights for improving the clinical management of adult bronchiectasis in China.