Update on non-cystic fibrosis bronchiectasis.
OBJECTIVE
There is growing awareness in both adult and paediatric respiratory clinics regarding the importance of non-cystic fibrosis bronchiectasis. There has been debate regarding the requirement for investigations to establish an underlying cause of bronchiectasis. Furthermore, there has been growing interest in establishing the role of bacteria in disease progression.


RESULTS
Post-infection is no longer the most common cause of bronchiectasis in developed countries in children or adults and the importance of identifying immunodeficiency has been underlined. Nontuberculous mycobacteria are recognized as both causing and complicating non-cystic fibrosis bronchiectasis. It has been suggested that infection with Pseudomonas aeruginosa may confer a worse prognosis compared with other pathogens but recent publications produce conflicting views. There is increasing recognition that patients with non-cystic fibrosis bronchiectasis do not necessarily respond to cystic fibrosis treatment regimens in the same way as patients with cystic fibrosis regimens.


CONCLUSIONS
Non-cystic fibrosis bronchiectasis can be approached in a systematic fashion to establish the underlying cause and develop treatment strategies.
Bilton
Diana
D
Royal Brompton Hospital, Sydney Street, London, UK. d.bilton@rbht.nhs.uk
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001987:Bronchiectasis / Q000188:drug therapy / Q000235:genetics* / Q000382:microbiology*; D002648:Child; D006801:Humans; D008168:Lung / Q000382:microbiology; D009161:Mycobacterium / Q000472:pathogenicity; D009164:Mycobacterium Infections / Q000150:complications; D011552:Pseudomonas Infections / Q000150:complications; D011550:Pseudomonas aeruginosa / Q000472:pathogenicity
D000900:Anti-Bacterial Agents