Bronchiectasis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Treatment of bronchiectasis is aimed at controlling infections and bronchial secretions, relieving airway obstruction, and preventing complications.

Medical Therapy

Common medical therapy for bronchiectasis includes prolonged usage of antibiotics to prevent detrimental infections[1], as well as eliminating accumulated fluid with postural drainage and chest physiotherapy. Surgery may also be used to treat localized bronchiectasis, removing obstructions that could cause progression of the disease.[2]

Inhaled steroid therapy that is consistently adhered to can reduce sputum production and decrease airway constriction over a period of time will prevent progression of bronchiectasis. One commonly used therapy is Beclometasone dipropionate, also used in asthma treatment.[3] Use of inhalers such as Albuterol (Salbutamol), Fluticasone (Flovent/Flixotide) and Ipratropium (Atrovent) may help reduce likelihood of infection by clearing the airways and decreasing inflammation.[4]

Mannitol dry inhalation powder, under the name Bronchitol, has been approved by the FDA for use in Cystic Fibrosis patients with Bronchiectasis. The original orphan drug indication approved in February 2005 allowed its use for the treatment of bronchiectasis. The original approval was based on the results of phase 2 clinical studies showing the product to be safe, well-tolerated, and effective for stimulating mucus hydration/clearance, thereby improving quality of life in patients with chronic obstructive lung diseases like Bronchiectasis. Long-term studies are currently underway to ensure the safety and effectiveness of the treatment, and it is not yet available on the market for use.

References

  1. Evans DJ, Bara AI,Greenstone M (2007). "Prolonged antibiotics for purulent bronchiectasis in children and adults". The Cochrane Database of Systematic Reviews (2). doi:10.1002/14651858.CD001392.pub2.
  2. Ötgün B, Karnak B, Tanyel K, Enocak M, Büyükpamukçu N (2003). "Surgical treatment of bronchiectasis in children". Journal of Pediatric Surgery. 39 (10): 1532–36.
  3. Elborn JS, Johnston B, Allen F, Clarke J, McGarry J, Varghese G. (1992). "Inhaled steroids in patients with bronchiectasis". Respir Med. 86 (2): 121–4. PMID 1615177.
  4. Reports, Consumer. "Ipratropium and Albuterol Inhalation - Drug Review". Consumer Reports of U.S.


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