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Management of non-cystic fibrosis bronchiectasis

SS Sunny, J Davison, A De Soyza

Non-cystic fibrosis bronchiectasis, often considered an ‘orphan disease’, represents a substantial cause of hospital admission and primary care consultations. As yet, the management of this chronic disease has been hampered by an inadequate evidence base. This has led to the occasionally inappropriate extrapolation of research from other chronic respiratory diseases with potentially different disease processes or trajectories, such as cystic fibrosis and chronic obstructive pulmonary disease. Recently, commercial interest in bronchiectasis has increased, raising the possibility of new evidence-based treatment options for the stable phases of the disease. These maintenance therapies include long-term antibiotic therapy and inhaled mucolytic therapies. This article reviews current clinical practice in the routine management of non-cystic fibrosis bronchiectasis and discusses emerging therapeutic options.