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Bronchiectasis - Management
What treatments for bronchiectasis may be initiated in secondary care?

  • All people with bronchiectasis should be referred to a respiratory physiotherapist for the teaching of an airway clearance technique.
    • People with a chronic productive cough should use the technique every day.
    • People who have a productive cough during exacerbations can use the technique intermittently (during an exacerbation).
  • All people with bronchiectasis who have breathlessness associated with activities of daily living should be offered pulmonary rehabilitation.
  • All people having three or more exacerbations a year, and those with fewer exacerbations causing significant morbidity, should be considered for long-term prophylactic treatment with antibiotics.
    • Nebulized antibiotics should be considered in adults chronically colonized with Pseudomonas aeruginosa.
    • Nebulized antibiotics should be considered in children with frequent recurrent exacerbations, or deteriorating bronchiectasis despite oral antibiotics, or if oral antibiotics are not appropriate.
  • Long-term treatment with theophylline, aminophylline, inhaled beta2-agonists, or inhaled anticholinergic bronchodilators should only be prescribed after a trial of therapy has demonstrated improvement of symptoms or lung function.
  • Lung resection surgery may be considered in people with localized disease when symptoms cannot be controlled by medical treatment.

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