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Treatment of bronchiectasis in adults

Alan F Barker, MD
Section Editors
James K Stoller, MD, MS
Talmadge E King, Jr, MD
Deputy Editor
Helen Hollingsworth, MD


Bronchiectasis is a syndrome of chronic cough and daily viscid sputum production associated with airway dilatation and bronchial wall thickening. Multiple conditions are associated with the development of bronchiectasis, but all require an infectious insult and usually also impairment of drainage, airway obstruction, and/or a defect in host defense.

Of the broad spectrum of causes of noncystic fibrosis bronchiectasis, only a few respond to direct treatment (eg, certain immunodeficiencies, nontuberculous mycobacterial infection, allergic bronchopulmonary aspergillosis). Instead, treatment of bronchiectasis is aimed at controlling infection, reducing inflammation, and improving bronchial hygiene [1,2]. Surgical extirpation of affected areas may be useful in selected patients.

The treatment of bronchiectasis will be reviewed here. The diagnosis and treatment of cystic fibrosis and the clinical manifestations and diagnosis of bronchiectasis are discussed separately. (See "Cystic fibrosis: Clinical manifestations and diagnosis" and "Cystic fibrosis: Overview of the treatment of lung disease" and "Cystic fibrosis: Antibiotic therapy for chronic pulmonary infection" and "Clinical manifestations and diagnosis of bronchiectasis in adults".)


For most causes of bronchiectasis, treatment of the underlying disease is not possible, as the bronchiectasis is a manifestation of scarring that resulted from a prior injury or infection (eg, severe pneumonia) or a result of an ongoing problem with secretion clearance that does not have a specific treatment (eg, primary ciliary dysfunction). However, some disease processes can be controlled to prevent further scarring. The evaluation and diagnosis of the underlying causes of bronchiectasis are discussed separately (table 1 and table 2 and table 3). (See "Clinical manifestations and diagnosis of bronchiectasis in adults".)

Examples of disease processes in which specific therapies may prevent progression of bronchiectasis include the following:

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Literature review current through: Nov 2017. | This topic last updated: Aug 03, 2017.
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