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How to Treat Bronchiectasis?


Things to note:
The education of patients. Early self- reference advice for suspected acute infections.
Physiotherapy:
  • Regular postural drainage is the main therapy and should be emphasized and shown to patients.
  • Regular home physiotherapy, including cough and chest drainage, and repeated emphasis should be placed on.

Medical Treatment:
Antimicrobial therapy
Antibiotic therapy should only be used in patients with bronchiectasis when sputum becomes more purulent than usual. The choice of antibiotics should always be guided by microscopy of sputum, culture and sensitivity.
Depending on the extent of the bronchiectasis and the organisms suspected, treatment may have to be extended for two weeks.
  • Amoxicillin / clavulanic acid, oral, 875/125 mg 12 hours for 10 days or longer depending on the response in patients otherwise stable and before cultivation results.
Penicillin allergy:
  • Moxifloxacin, oral, 400 mg daily for at least 10 days or more depending on the response.
More seriously ill patients may need to be hospitalized and parenteral antibiotics therapy initiated. In all cases, sputum culture and sensitivity determination are indicated.
  • Ampicillin, IV, 6 hours for 1 g.
PLUS
  • Gentamicin, IV, daily 6 mg / kg.
Upon improvement, switch to oral treatment:
  • Amoxicillin / clavulanic acid, oral, 875/125 mg 12 hours.
The results of sputum tests should be used for further antibiotic therapy.
Inhaled bronchodilators
Bronchodilators may be used for asthma or COPD if an obstruction of airflow occurs.
For inhaled corticosteroids, there is no indication.
Prophylaxis
Prophylaxis Annual influenza vaccine

When to refer:
  • To exclude a possible external body.
  • Assessment for bronchiectatic segment surgical removal.
  • The biggest haemoptysis.