Bronchiectasis secondary prevention: Difference between revisions
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*National guidelines recommend that patients suffering from three or more exacerbations per year, should be considered for long-term antibiotics.<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208 }} </ref> | *National guidelines recommend that patients suffering from three or more exacerbations per year, should be considered for long-term antibiotics.<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208 }} </ref> | ||
*[[Macrolide]] daily or three times weekly | *[[Macrolide]] daily or three times weekly | ||
: | :*[[Macrolides]] exhibit anti-bacterial and [[immunomodulatory]] effects.<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208 }} </ref> | ||
*[[Amoxicillin]] 500 mg twice daily or doxycycline 100 mg twice daily for patients who are not candidates for long-term macrolide administration | *[[Amoxicillin]] 500 mg twice daily or doxycycline 100 mg twice daily for patients who are not candidates for long-term macrolide administration | ||
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====Physiotherapy Strategies==== | ====Physiotherapy Strategies==== | ||
Airway Clearance | *Airway Clearance | ||
*Postural Drainage | :*Postural Drainage | ||
*Autogenic Drainage | :*Autogenic Drainage | ||
*Active Cycle of Breathing Techniques | :*Active Cycle of Breathing Techniques | ||
*Positive Expiratory Pressure (PEP) | :*Positive Expiratory Pressure (PEP) | ||
*Oscillatory PEP devices | :*Oscillatory PEP devices | ||
*High-frequency chest wall [[percussion]] | :*High-frequency chest wall [[percussion]] | ||
Pulmonary Rehabilitation | *Pulmonary Rehabilitation | ||
*Exercise training | :*Exercise training | ||
*Nutritional counseling | :*Nutritional counseling | ||
*Educationof the patient's disease and how to manage it | :*Educationof the patient's disease and how to manage it | ||
*Techniques on how to conserve energy | :*Techniques on how to conserve energy | ||
*Strategies on breathing | :*Strategies on breathing | ||
*Psychological counseling | :*Psychological counseling | ||
==References== | ==References== |
Revision as of 14:05, 1 July 2015
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Overview
To reduce the impact of the disease, patients should lead a healthy lifestyle, use prophylactic treatment when needed, do vaccinations, and practice physiotherapy strategies.
Bronchiectasis Secondary Prevention
Healthy Lifestyle
- Smoking cessation
- Exercise
- Maintain a healthy BMI
Prophylactic Treatment
- National guidelines recommend that patients suffering from three or more exacerbations per year, should be considered for long-term antibiotics.[1]
- Macrolide daily or three times weekly
- Macrolides exhibit anti-bacterial and immunomodulatory effects.[1]
- Amoxicillin 500 mg twice daily or doxycycline 100 mg twice daily for patients who are not candidates for long-term macrolide administration
Vaccination
- There has been some evidence to support that the yearly influenza vaccine reduces morbidity, mortality, and healthcare costs with high-risk patients
Physiotherapy Strategies
- Airway Clearance
- Postural Drainage
- Autogenic Drainage
- Active Cycle of Breathing Techniques
- Positive Expiratory Pressure (PEP)
- Oscillatory PEP devices
- High-frequency chest wall percussion
- Pulmonary Rehabilitation
- Exercise training
- Nutritional counseling
- Educationof the patient's disease and how to manage it
- Techniques on how to conserve energy
- Strategies on breathing
- Psychological counseling
References
- ↑ 1.0 1.1 McDonnell MJ, Ward C, Lordan JL, Rutherford RM (2013). "Non-cystic fibrosis bronchiectasis". QJM. 106 (8): 709–15. doi:10.1093/qjmed/hct109. PMID 23728208.