Long-term antibiotic treatment for non-cystic fibrosis bronchiectasis in adults: evidence, current practice and future use.
Bronchiectasis is defined pathologically by the permanent dilation of the bronchi and bronchioles and chronic airway inflammation. This is the outcome of a number of different aetiologies but up to half of bronchiectasis cases are labelled idiopathic. It is characterised by a chronic productive cough, haemoptysis, shortness of breath and recurrent infective exacerbations. Long-term antibiotics are used with the aim of reducing symptom severity and exacerbation frequency, improving quality of life and preventing disease progression. Areas covered: This perspective provides an overview of evidence and current practice for long-term oral, inhaled and pulsed intravenous antibiotic therapy in adults with non-cystic fibrosis bronchiectasis. Evidence was drawn from a recent systemic literature review. Expert commentary: An approach to long-term antibiotic treatment is provided. Side effects of treatment, methods of monitoring treatment success and actions to be considered if treatment fails are discussed. Emerging long-term antibiotic treatments and strategies are considered.
a Host Defence Unit , Royal Brompton Hospital , London , UK.
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N
Goldman
a Host Defence Unit , Royal Brompton Hospital , London , UK.
M R
MR
Loebinger
a Host Defence Unit , Royal Brompton Hospital , London , UK.
R
R
Wilson
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000150:complications / Q000188:drug therapy*; D018450:Disease Progression; D004334:Drug Administration Schedule; D006801:Humans; D011788:Quality of Life; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
Bronchiectasis; Pseudomonas aeruginosa; antibiotic resistance; long-term antibiotics; macrolide antibiotics; nebulised antibiotics