The social and medical costs of
bronchiectasis in children are becoming considerable due to its increasing prevalence. Early identification and intensive treatment of
bronchiectasis are needed to decrease the morbidity and mortality associated with
bronchiectasis in children.
AREAS COVERED: Evidence for the effectiveness of diverse treatment strategies in
bronchiectasis is lacking, particularly in children, although the disease burden is substantial for
bronchiectasis. Most treatment strategies for non-
cystic fibrosis bronchiectasis in children have been extrapolated from those in adults with
bronchiectasis or children with
cystic fibrosis.
Antibiotics combined with an active airway clearance
therapy via the inhalation of mucoactive agents can stabilize
bronchiectasis. The timely and intensive administration of
antibiotics during acute exacerbation of
bronchiectasis is essential to prevent its progression in children. To suppress the bacterial loads in the airway, systemic or inhaled
antibiotics can be administered intermittently or continuously. However, studies on these protocols, including the appropriate duration and effective dosages are lacking. Long-term administration of
azithromycin for 12-24 months may reduce the exacerbation frequency with the increased carriage rate of
azithromycin-resistant bacteria.