Overview

The aims of managing bronchiectasis are to improve symptoms and quality of life, minimise exacerbations and limit disease progression.

Management of bronchiectasis associated with cystic fibrosis differs from management of bronchiectasis associated with other causes.

Key components of bronchiectasis management in adults include:

• exercise and pulmonary rehabilitation
• airway clearance
• general measures (eg developing action plans, smoking cessation, immunisation, nutrition, managing causes and comorbidities, spirometry testing)
• treating infective exacerbations
• managing haemoptysis.

Very rarely, surgical removal of a severely damaged section of lung may be helpful.

Bronchodilators and corticosteroids have a limited role in the treatment of bronchiectasis.

Stable bronchiectasis in adults can be managed in primary care. Refer to a respiratory physician in patients with:

• rapid progression of disease or symptoms
• disease requiring hospitalisation
• severe respiratory symptoms
• lack of response to treatment
• recurrent exacerbations (more than three per year)
• resistant or unusual organisms isolated in sputum (eg nontuberculous mycobacteria, Pseudomonas aeruginosa)
• haemoptysis.

Bronchiectasis in children should be managed by a specialist. Treatment involves airway clearance, exercise, antibiotic therapy, immunisations and optimisation of nutrition and growth.

The Lung Foundation Australia website publishes fact sheets on bronchiectasis for patients and health professionals, including stepwise management of stable bronchiectasis.