Respiratory — Updates Since 2020

Guideline & practice changes since 2020

• The National Lung Cancer Screening Program (NLCSP) launched July 2025 — Australia’s first Medicare-funded lung cancer screening program. See Lung Cancer & Screening.
• COPD stepwise pharmacotherapy now follows the COPD-X Handbook’s current figure (START short-acting reliever → ADD long-acting bronchodilator → CONSIDER triple therapy only for ≥1 severe/≥2 moderate exacerbations in 12 months), COVID-19 added to the vaccination schedule, and a corrected >18hr/day LTOT threshold. See COPD.
• 2023 BTS Pleural Disease guideline: pneumothorax management is now symptom-based, not size-based; indwelling pleural catheters are now first-choice for malignant effusion over talc pleurodesis. See Pleural Effusion.
• 2023 TSANZ bronchiectasis position statement: 14-day exacerbation antibiotics, P. aeruginosa eradication, and a defined macrolide-prophylaxis threshold. See Bronchiectasis.
• GP-led latent TB infection management is now a recognised model, previously framed as specialist-only. See Tuberculosis.
• 2022 ATS/ERS/JRS/ALAT Progressive Pulmonary Fibrosis framework extends antifibrotic eligibility beyond IPF; the same guideline also recommends against antireflux medication or surgery specifically to treat IPF, despite GORD’s association with the disease — treating GORD doesn’t appear to alter the fibrotic course. See Interstitial Lung Diseases.
• GLI-2012/z-score spirometry interpretation is now the standard (replacing older reference equations).
• ASCIA 2024/2026 anaphylaxis guideline: neffy (a needle-free intranasal adrenaline device), Anapen now 500mcg, and Action Plans reflect nurse-practitioner prescribing. See Anaphylaxis.
• GPs can now order sleep studies directly without prior specialist review; also covers COMISA (comorbid insomnia and OSA) and the SURMOUNT-OSA tirzepatide trial as evolving, not yet established. **Obesity hypoventilation syndrome’s BMI threshold is

  30 kg/m² (StatPearls), not >35** as previously stated, and adaptive servo-ventilation is contraindicated in HFrEF (SERVE-HF mortality signal). See Obstructive Sleep Apnoea.

• Paediatric inhaled foreign body: ~50% present asymptomatically and up to 25% have a normal CXR. See Inhaled Foreign Body.
• Pneumonia rewritten against the HNE CAP-Adult pathway rather than the 2025 US ATS/IDSA guideline — the Australian source took priority. See Pneumonia.

New pages added

• Asthma Diagnosis
• Occupational Lung Disease — silicosis/ pneumoconiosis; the engineered-stone silicosis epidemic and new NORDR registry (May 2024) move fast.
• Acute Viral Respiratory Tract Infections — the common cold, laryngitis and acute bronchitis merged into one page (Page Organisation, 2026-08-29).
• COVID-19 & Post-COVID-19 Condition — new page (2026-08-31): testing (RAT vs NAAT), current PBS nirmatrelvir/ritonavir eligibility criteria, and post-COVID-19 condition (“long COVID”) assessment, investigation and management.

RSV prevention is covered as a cross-reference in Influenza.