Antimicrobial treatment of non-cystic fibrosis bronchiectasis.

Abstract

Bronchiectasis unrelated to cystic fibrosis is characterized by chronic wet or productive cough, recurrent exacerbations and irreversible bronchial dilatation. After antibiotics and vaccines became available and living standards in affluent countries improved, its resulting reduced prevalence meant bronchiectasis was considered an 'orphan disease'. This perception has changed recently with increasing use of CT scans to diagnose bronchiectasis, including in those with severe chronic obstructive pulmonary disease or 'difficult to control' asthma, and adds to its already known importance in non-affluent countries and disadvantaged Indigenous communities. Following years of neglect, there is renewed interest in identifying the pathogenetic mechanisms of bronchiectasis, including the role of infection, and conducting clinical trials. This is providing much needed evidence to guide antimicrobial therapy, which has relied previously upon extrapolating treatments used in cystic fibrosis and chronic obstructive pulmonary disease. While many knowledge gaps and management challenges remain, the future is improving for patients with bronchiectasis.

• Authors: Keith Grimwood, Scott C Bell, Anne B Chang
• Journal: Expert review of anti-infective therapy (Expert Rev Anti Infect Ther) Vol. 12 Issue 10 Pg. 1277-96 (Oct 2014) ISSN: 1744-8336 [Electronic] England
• PMID: 25156239 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anti-Bacterial Agents
• Vaccines

Topics

• Adult
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Bronchiectasis (drug therapy, epidemiology, microbiology)
• Child
• Humans
• Randomized Controlled Trials as Topic
• Vaccines (administration & dosage, therapeutic use)