Treatment of bronchiectasis in adults

This is the authors' abstract. We don't add key points for this paper.

#### Summary points Patients with bronchiectasis usually need lifelong medical support from their doctor, especially given the frequent episodes of infection. This article focuses on the treatment of bronchiectasis in adults and does not include a discussion of bronchiectasis caused by cystic fibrosis. The prevalence of bronchiectasis not linked to cystic fibrosis is unclear, but every general practitioner in the United Kingdom probably has a few patients. Bronchiectasis refers to the permanent abnormal dilatation of the central and medium sized bronchi as a result of a vicious cycle of transmural infection and inflammation with mediator release.1 Symptoms include chronic productive cough, wheeze, and dyspnoea. Infective exacerbations are associated with worsening of symptoms and signs of pneumonia. Haemoptysis can occur, but amounts of blood are usually small, and serious haemoptysis requiring selective arteriography and embolisation or surgery is rare. The most frequently used classification system distinguishes between cylindrical, varicose, and saccular or cystic bronchiectasis.w1 Although insightful, this classification has no clinical or therapeutic uses. A modern clinical definition includes the daily production of mucopurulent phlegm and chest imaging that demonstrates dilated and thickened airways.w2 The clinical suspicion of bronchiectasis …