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REVIEW ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 43-50

Exacerbations of bronchiectasis in adults


1 Department of Pulmonology, Centro Hospitalar de Sao Joao, Porto, Portugal
2 Department of Pulmonology, Universitary Hospital of Catania "G. Rodolico", Catania, Italy
3 Scottish Centre for Respiratory Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom

Correspondence Address:
Dr. James D Chalmers
Scottish Centre for Respiratory Research, University of Dundee, Dundee, DD1 9SY
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2225-6482.184910

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Exacerbations are significant events in the course of bronchiectasis. Exacerbations are associated with accelerated lung function decline and deterioration in quality of life (QoL). Prevention of exacerbations is therefore one of the key objectives of management of bronchiectasis. A few treatments have been proven to reduce the risk of exacerbations, but these include the treatment of underlying causes of bronchiectasis and the use of prophylactic antibiotic therapies (macrolides and inhaled antibiotics). Nonantibiotic therapies, such as airway clearance and pulmonary rehabilitation, also play an important role in the prevention of exacerbations. Acute exacerbations are treated with antibiotics directed against the known bronchiectasis pathogens and guided by previous sputum culture results. This emphasizes the importance of screening sputum cultures in stable patients. Assessment of severity is used to determine whether patients should be treated at home or in hospital. Supportive therapy for exacerbations should include airway clearance alongside oxygen, hydration, and treatment of bronchospasm as required. Bronchiectasis is a rapidly developing field and new therapies, both for the prevention of exacerbations and the treatment of acute exacerbations, are currently being developed.


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