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Pneumology

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Question:

What is the treatment course of bronchiectasis?

Author: H K



Answer:

Treat underlying disease (injury/ infection/ immunodef (IVIG/ SCIG)/tracheobronchomegaly (stent in airway), some can be controlled to prevent scarring) Treat acute exacerbations (infections (more sputum darker color, with other symptoms ans systemic complaints), pneumothorax/ pneumonia ) Oral antibiotic treatment (stable pt) IV treatment (sputum with pseudomonas (nonquinolone tx of pseudomonas given IV), hospitalization (exacerbations), aminoglycosides (may be nephrotoxic/ ototoxic so monitor it), some are hard to eradicate (aspergillus (central bronchiectasis), Mycobacteria avium MAC) -therapy prednisone 0.5-1 mg'kg for 2 weeks, 16 week anti-fungals) Prevention of exacerbation Abx (macrolide usually - chronic low dose) Airway clearance therapy (directed cough, exercise, forced expiration, chest physical exercise, PEP...) Others (dilators, anti inflammatory, statin (NSAID), PPI and H2 blockers for GERD complication, pulmonary rehab


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H K
H K