Key Points

  • In bronchiectasis chronic inflammation from various causes destroys the structure and muscle in the airway walls in medium to smaller sized airways, resulting in irreversible damage and dilated airways that are chronically colonised by infectious organisms.
  • Patients have a chronic productive cough with intermittent acute exacerbations, usually 2 to 3 times/year.
  • Diagnosis is with high resolution CT scan.
  • Regular mucus cultures should be done to identify colonising organism(s) prior to starting antibiotic therapy is possible.
  • Exacerbations can be reduced by using appropriate daily airway clearance techniques, immunisations and sometimes long term macrolide antibiotics. In certain cases long term nebulised antibiotics are used.
  • Treat exacerbations with antibiotics, bronchodilators, more frequent and additional airway clearance measures.