title: 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.affiliation: Griffith Health Institute, Griffith University, Gold Coast, QLD 4222, Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Grimwood
authors.forename: Scott C
authors.initials: SC
authors.lastname: Bell
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D014612:Vaccines / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014612:Vaccines
keywords: Haemophilus influenzae; Pseudomonas aeruginosa; amikacin; azithromycin; bronchiectasis; colistin; microbiota; non-tuberculous mycobacteria; respiratory viruses; tobramycin