There is no cure for bronchiectasis because the damage to the airways can’t be reversed, but its symptoms and lung infections can be treated. The goal is to treat the underlying conditions and lung infections, to remove mucus from the lungs, and to prevent further complications.
Medicines prescribed for bronchiectasis treatment
Some of the medicines or treatments usually prescribed for bronchiectasis are antibiotics, bronchodilators, expectorants, and mucus-thinning drugs. In most cases, treatment involves a combination of medication and the use of devices and exercises to help clear the airways.
Antibiotics are the most common treatment for lung infections, which can be common in people with bronchiectasis. Some people take continuous antibiotics because they get a lot of infections. Antibiotics may be taken orally, or in case of more difficult to treat infections, they may be given intravenously.
Intravenous antibiotics may be required in severe cases, or where oral use fails to treat an acute exacerbation. IV antibiotics currently in use for such cases are benzylpenicillin, cefuroxime, ceftriaxone vancomycin, ceftazidime and cefuroxime.
Long-term antibiotics are used in people with bronchiectasis to improve disease symptoms, decrease exacerbation rates, and improve quality of life. These include amoxicillin, flucloxacillin and trimethoprim.
The choice of the adequate antibiotic will depend on the specific bacteria that is causing the infection.
Bronchodilators for bronchiectasis
Bronchodilators relax the muscles around the airways. The majority of the bronchodilators are inhaled medications, taken using an inhaler or a nebulizer. They help to open the airways so breathing is easier.
The bronchodilators commonly used for bronchiectasis include short-acting bronchodilators, such as albuterol and levalbuterol, and long-acting bronchodilators, such as formoterol, tiotropium and salmeterol.
Short-acting bronchodilators are used as a rescue medication when there is a need for quick relief of shortness of breath, and long-acting bronchodilators are used regularly to control bronchiectasis symptoms.
Expectorants and mucus-thinning medicines for bronchiectasis
Expectorants and mucus thinning medicines help to clear mucus. Both work to loosen the mucus in the lungs, making it easier to cough out of the airways. Expectorants or mucus clearance agents, include hypertonic saline and inhaled mannitol, that keeps the airways hydrated and enhance clearance and mucolytics, such as bromhexine, N-acetyl cysteine, erdosteine and fudosteine, and dornase alfa.
Expectorants may be combined with decongestants.
Other bronchiectasis treatments include hydration, which turns the mucus thinner and easier to cough up; chest physical therapy (chest clapping or percussion) done by a therapist or trained family member, using their hands or an external device, to loosen mucus and help move it out of the lungs, or with an external device, like therapy vest that uses high-frequency air waves; oxygen therapy to raise low blood-oxygen levels; and corticosteroids to treat airway inflammation.
Surgery may be considered if other treatments do not help and only one part of the airway is affected, if symptoms aren’t responding to other treatment or if major bleeding takes place.