Bronchiectasis in Italy: an analysis of the EMBARC Registry

Background Bronchiectasis (BE) is a complex disease with geographical variability in its presentation and management. Despite the growing contribution of international registries, real-world data on the Italian BE population remain limited. Objective To describe the demographic, clinical, microbiological, functional, and treatment characteristics of Italian patients with BE and to compare them with those of patients from other Southern European countries (SEC). Methods This was a secondary analysis of adults from 18 Italian centers included in the EMBARC registry, with comparisons made to patients Spain, Greece, Portugal, Turkey, Israel, and Malta (SEC). Demographics, comorbidities, exacerbation history, spirometry, microbiology, and treatment patterns were evaluated. Results Among 1657 Italian patients, the majority were female (70.5%) with a median age of 65 years, with high rates of idiopathic BE (55.4%) and preserved lung function. Compared to other SEC (n=2638), Italian patients had lower disease severity (BSI score: 6 versus 7, p <0.001), less frequent isolation of P. aeruginosa , and lower prevalence of daily sputum production and purulence, despite identical quality of life (QoL-B Respiratory Symptom Score: median 70.4 in both groups). Treatment patterns differed, with lower use of inhaled antibiotics (1.1% versus 13.1%) and macrolides (6.0% versus 14.3%), but more widespread use of airway clearance (48.4% versus 35.9%) among patients from Italy versus other SEC. Conclusions These findings may reflect earlier referral, diagnostic preferences, or structural differences in care delivery in Italy compared with other SEC. This work lays the foundation for tailored national strategies and future longitudinal studies.