17th February 2025

Management of bronchiectasis

The mainstay of management is to treat any underlying cause and minimise the frequency and severity of exacerbations.

• Physiotherapy is key in minimising exacerbations and preventing progression of lung disease. Techniques such as postural drainage and active cycle breathing help to clear the airway
• Antibiotics are used for exacerbations and, in some cases, for long-term prophylaxis.
  • Antibiotics can be nebulised, oral or intravenous
  • Patients will normally need a higher dose and longer course (usually 2 weeks) of antibiotics
  • Pseudomonas colonisation is a poor prognostic marker, associated with worse lung function, more frequent exacerbations and more severe disease
• Bronchodilators and inhaled steroids are used if there are symptoms or evidence of  airflow obstruction
• Annual influenza and pneumococcal vaccinations
• Surgical input can be curative if the disease is localised
• Lung transplant can be considered in some specific, severe cases