Medication-Based Treatment

Bronchodilators

Bronchodilators are drugs that relax and open your airways, so air can flow more freely into your lungs allowing you to breathe more easily. Bronchodilators are used before an airway clearance session to help with mucus clearance. Salbutamol (or albuterol) is a commonly used bronchodilator that is inhaled using an inhaler (puffer) and a valved holding chamber or a nebulizer.

Mucus Thinners 

Hypertonic saline is a sterile saline solution with a salt (NaCl) content of 1% or higher that is used to hydrate and loosen mucus, making it easier to cough up. Hypertonic saline is inhaled using a nebulizer.

Antibiotics 

Antibiotics prevent, treat or control lung infections caused by bacteria such as Pseudomonas aeruginosa that grows in the mucus. Antibiotics may be given by mouth (orally), by inhalation using a nebulizer or inhaler or intravenously (IV).

Vaccinations

Influenza (flu) vaccines may help reduce the chance of complications to your condition from bacterial infection.¹⁹

Surgery and Organ Transplant

Lung surgery may be considered if you have bronchiectasis in a limited area of one lung and have not responded to other treatments.³ Lung transplantation may be a viable therapeutic option if you have very severe bronchiectasis and no other treatment options.³

References

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2. Martina Contarini. Bronchiectasis: a case-based approach to investigation and management. European Respiratory Review 2018;27:180016. https://err.ersjournals.com/content/27/149/180016.

3. Living with Bronchiectasis. British Lung Foundation 2017;BK33 Version 1. https://www.blf.org.uk/sites/default/files/BK33_Bronchiectasis_v1_2017_PDFdownload.pdf (Last accessed January 17, 2024).

4. Alan F Barker. Bronchiectasis. The New England Journal of Medicine 2002.;346:1383-1393. https://www.nejm.org/doi/full/10.1056/NEJMra012519.

5. Bronchiectasis. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/bronchiectasis (Last accessed January 17, 2024).

6. Bronchiectasis Frequently Asked Questions (FAQs). Bronchiectasis and NTM 360°. https://www.bronchiectasisandntminitiative.org/Learn-More/I-am-a-Patient-or-Caregiver/Bronchiectasis-FAQs (Last accessed February 23, 2024). 

7. Doreen Addrizzo-Harris, et al. Living Well With Bronchiectasis Patient Information Guide. CHEST Foundation 2017. https://foundation.chestnet.org/wp-content/uploads/2020/05/Bronchiectasis-Living-Well.pdf (Last accessed January 17, 2024).

8. Bronchiectasis in children. British Lung Foundation. https://www.blf.org.uk/support-for-you/bronchiectasis-in-children/what-is-it (Last accessed January 17, 2024).

9. Galit Livnat, et al. Non-cystic fibrosis bronchiectasis: review and recent advances. F1000 Medicine Reports 2009;1:67. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948306/.

10. Jaafer Saadi Imam, Alexander G Duarte. Non-CF bronchiectasis: Orphan disease no longer. Respiratory Medicine. 2020;166:105940. https://www.sciencedirect.com/science/article/pii/S0954611120300809

11. Adam T Hill, et al. British Thoracic Society Guideline for Bronchiectasis in Adults. Thorax 2019;74(1):1-69. http://dx.doi.org/10.1136/thoraxjnl-2018-212463.

12. Bronchiectasis in children. British Lung Foundation. https://www.blf.org.uk/support-for-you/bronchiectasis-in-children/what-is-it (Last accessed January 17, 2024).

13.  MP Murray, et al. Sputum colour: a useful clinical tool in non-cystic fibrosis bronchiectasis. European Respiratory Journal 2009;34(2):361-364. https://erj.ersjournals.com/content/34/2/361.

14. How is bronchiectasis diagnosed? British Lung Foundation. https://www.blf.org.uk/support-for-you/bronchiectasis/diagnosis (Last accessed January 17, 2024)..

15. Severity assessment. EMBARC The European Bronchiectasis Registry. https://www.bronchiectasis.eu/severity-assessment (Last accessed January 17, 2024).

16. Bronchiectasis: Symptoms. National Jewish Health. https://www.nationaljewish.org/conditions/bronchiectasis/bronchiectasis-overview/symptoms (Last accessed January 17, 2024).

17. What is the treatment for bronchiectasis? British Lung Foundation. https://www.blf.org.uk/support-for-you/bronchiectasis/treatment (Last accessed January 17, 2024).

18. Annemarie L Lee, et al. Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis. Frontiers in Pediatrics 2017;5(2):1-8. https://doi.org/10.3389/fped.2017.00002.

19. Eva Polverino, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. European Respiratory Journal 2017;50:1700629. DOI: 10.1183/13993003.00629-2017. https://erj.ersjournals.com/content/50/3/1700629.

20. Bronchiectasis Toolbox. https://bronchiectasis.com.au/bronchiectasis/living-with-bronchiectasis/nutrition (Last accessed January 17, 2024).