Materiały źródłowe

• #1 Exacerbation Prevention and Management of Bronchiectasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10323201/

  Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. […] Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. […] Good performance of ACT has been believed to improve sputum clearance and elevate the quality of life in bronchiectasis patients; however, there is a paucity of randomized controlled studies that investigate the effect of ACT on bronchiectasis patients.

• #1

  https://www.nhs.uk/conditions/bronchiectasis/treatment/

  The damage to the lungs associated with bronchiectasis is permanent, but treatment can help prevent the condition getting worse. […] There are also a number of things you can do to help relieve the symptoms of bronchiectasis and stop the condition getting worse. […] These include: stopping smoking (if you smoke), having the flu vaccine every year, making sure you have had the pneumococcal vaccine to protect against pneumonia, exercising regularly, keeping yourself well hydrated, eating a balanced diet. […] If you have 3 or more infective exacerbations in any 1 year or your symptoms during an infective exacerbation were particularly severe, it may be recommended that you take antibiotics on a long-term basis. […] This can help prevent further infections and give your lungs the chance to recover.

• #1 Bronchiectasis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/bronchiectasis.html

  The following steps can help prevent bronchiectasis: […] Quickly treat any condition that can cause bronchiectasis. […] Early treatment of respiratory illnesses can help prevent bronchiectasis. It can also keep it from getting worse.

• #1 Bronchiectasis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/21144-bronchiectasis

  You can reduce your risk of developing bronchiectasis by managing your lung health: […] Make sure you and your family are up-to-date on recommended vaccinations. Pertussis, the flu, pneumococcal disease and measles can all cause or worsen bronchiectasis. […] Work with your healthcare provider to treat any ongoing health conditions, especially ones that affect your lungs. Keep your appointments and stick to your treatment plan. Talk to your provider if you feel like medications or therapies arent working. […] Avoid breathing in things that can hurt your lungs, like cigarette smoke, vaping, fumes and gases.

• #1 Treating and Managing Bronchiectasis | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis/treating-and-managing

  The goal of bronchiectasis treatment is to treat any underlying conditions, prevent lung infections, remove excess mucus, and prevent flare-ups, also called exacerbations. […] You should also work closely with your healthcare provider to determine healthy habits that will help manage your symptoms and decrease the risk of flare-ups. Some suggestions may be: Quit smoking and avoid secondhand smoke. Maintain a healthy diet, low in sodium, added sugars, saturated fats and refined grains. Stay hydrated, drinking plenty of water to help prevent mucus build-up. Be diligent about taking prescribed oral and inhaled medications and performing mucus clearance techniques daily. Staying up to date on recommended vaccinations. Take antibiotics as prescribed by your healthcare provider during flare-ups.

• #1 Bronchiectasis – What You Need to Know

  https://www.drugs.com/cg/bronchiectasis.html

  Go to pulmonary rehabilitation (rehab) as directed. Pulmonary rehab is a program that can help you learn how to manage bronchiectasis and prevent exacerbations. Your plan will include aerobic exercise, such as walking, swimming, or riding a bicycle. Regular exercise helps your lungs work well and helps keep your airway clear. Rehab can help you increase your ability to exercise for as long as recommended. […] Do not smoke or be around anyone who is smoking. Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make breathing problems worse. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. […] Ask about vaccines you may need. Vaccines can help prevent some lung infections. Examples include pneumonia, pertussis (whooping cough), diphtheria, and influenza (flu). Get a flu vaccine every year as soon as recommended, usually starting in September or October. Your healthcare provider will tell you if you need other vaccines, and when to get them.

• #1 Bronchiectasis in Malaysia: Symptoms, Causes, Treatment & Prevention

  https://chestspecialistmalaysia.com/bronchiectasis-in-malaysia-symptoms-causes-treatment-prevention/

  Vaccination plays a pivotal role in reducing the risk of future infections by up to an impressive 70%. To provide comprehensive protection, I often recommend three specific types of vaccinations: Pneumococcal 13 Vaccination, Influenza Vaccination, and Pneumococcal 23 Vaccination. By ensuring completion of these three vaccinations, patients can bolster their lung defenses significantly. Vaccination serves as a proactive step in preventing infections that could further strain the respiratory system. […] The unique lung anatomy of bronchiectasis patients, often altered by scarring, can trap mucus and secretions in their airways. This provides a breeding ground for bacterial and viral invaders. To counteract this challenge, pulmonary rehabilitation and chest physiotherapy emerge as invaluable allies.

• #1 Bronchiectasis – Lung and Airway Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/lung-and-airway-disorders/bronchiectasis-and-atelectasis/bronchiectasis

  Early identification and treatment of conditions that tend to cause bronchiectasis may prevent its development or reduce its severity. […] Childhood immunizations against measles and pertussis (whooping cough), improved living conditions, and better nutrition have markedly reduced the number of people who develop bronchiectasis. […] Pneumococcal vaccination, COVID-19 vaccination, respiratory syncytial virus (RSV) vaccination in some people, annual influenza vaccination, and use of appropriate antibiotics early in the course of lung infections help to prevent bronchiectasis or reduce its severity. […] Other specific steps that can be taken include the following: Receiving immunoglobulin for an immunoglobulin deficiency syndrome may prevent recurring infections. […] In people who have allergic bronchopulmonary aspergillosis, using corticosteroids appropriately and sometimes an antifungal medication (such as itraconazole) may reduce the bronchial damage that results in bronchiectasis.

• #1 Therapeutic Management of Bronchiectasis in Children and Adolescents: A Concise Narrative Review

  https://www.mdpi.com/2077-0383/13/16/4757

  The use of macrolides, in a long-term low-dose schedule, is recommended by the ERS guidelines in order to minimize exacerbations. Notably, macrolides also display significant immunomodulatory properties in several lung diseases, from severe asthma to bronchiolitis obliterans. […] The guidelines recommend treatment with long-term macrolide antibiotics to reduce exacerbations in children and adolescents with bronchiectasis and recurrent exacerbations, particularly in those who have had more than one hospitalized or three or more non-hospitalized exacerbations in the previous 12 months. […] The guidelines suggest that children/adolescents with bronchiectasis are fully immunized according to their national immunization programs, including pneumococcal and annual seasonal influenza vaccines if these are not part of this program.

• #1 Bronchiectasis in adults: Maintaining lung health – UpToDate

  https://www.uptodate.com/contents/bronchiectasis-in-adults-maintaining-lung-health

  Bronchiectasis is a condition of chronic cough and daily viscid sputum production associated with airway dilatation and bronchial wall thickening. Multiple conditions are associated with the development of bronchiectasis, but all require an infectious insult and usually also impaired drainage, airway obstruction, and/or a defect in host defense. […] Avoidance of lung irritants — We advise patients to avoid exposure to respiratory irritants as much as possible. In particular, we strongly encourage cessation of smoking tobacco and vaping. Other irritants, such as smoke from indoor fires and occupational exposures (eg, cleaning agents, dust, fumes), should also be avoided. […] Airway clearance therapy — We suggest that all patients with bronchiectasis utilize regular physiotherapy to clear airway secretions. Bronchiectasis is the prototypical disease for which secretion loosening combined with enhanced removal techniques should be salutary, although large population and long-term studies of efficacy are lacking. Based on clinical experience, airway clearance techniques (also known as bronchial hygiene) improve cough and help patients to expectorate the tenacious secretions and mucous plugs that frequently complicate bronchiectasis. Airway clearance management is often underutilized. Adherence to airway clearance therapy is better with patients who are more severely impaired.

• #1 Bronchiectasis primary prevention – wikidoc

  https://www.wikidoc.org/index.php/Bronchiectasis_primary_prevention

  Primary prevention of bronchiectasis is aimed at the prevention of future development with the avoidance of harmful substances, vaccinations, maintenance of a healthy Body Mass Index (BMI), and the practice of physiologic strategies. […] Avoidance of toxic fumes, gases, smoke, and other harmful substances […] A healthy Body Mass Index, vaccination (especially against pneumonia and influenza), and regular doctor visits may have beneficial effects […] Physiotherapy strategies […] Airway clearance […] Postural drainage […] Autogenic drainage […] Active Cycle of breathing techniques […] Positive expiratory pressure (PEP) […] Oscillatory PEP devices […] High-frequency chest wall percussion […] Pulmonary rehabilitation […] Exercise training […] Nutritional counseling […] Education of the patient’s disease and how to manage it […] Techniques on how to conserve energy […] Strategies on breathing […] Psychological counseling.

• #1 Bronchiectasis exacerbation: a narrative review of causes, risk factors, management and prevention

  https://atm.amegroups.org/article/view/104705/html

  Therefore, frequent exacerbations result in disease progression and high mortality. […] Hence, clinicians should intervene in one or all of these key components with the goal of reducing exacerbations. […] Regular airway clearance has been shown to reduce exacerbations, most recently in a 12-month RCT. […] The international guidelines recommend inhaled antibiotics to eradicate and suppress P. aeruginosa in frequent exacerbators. […] The international bronchiectasis guidelines recommend long-term macrolides for frequent exacerbators without chronic P. aeruginosa infection. […] A novel drug that directly targets neutrophilic inflammation in bronchiectasis is currently under development.

• #1 Bronchiectasis and Pneumonia tips on prevention | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/bronchiectasis-and-pneumonia-tips-on-prevention/

  Maybe at the top of the list should be consistent daily airway clearance. Many pulmonologists recommend twice daily 7% saline via nebulizer followed by an airway clearance routine, which may include Active Cycle of Breathing and Autogenic Drainage. […] Lastly, learn to recognize the prodrome to pneumonia. […] The key is to „catch it” before it progresses to pneumonia. Other prodromes might include fatigue, headache, malaise, lack of appetite, increased coughing, etc. […] The winter before this one, I had repeated respiratory infections despite airway clearance. This past fall, he recommended I try 7% hypertonic saline a few times a week to see if it would decrease them. […] I use 7 percent saline solution in my nebulizer.

• #1 Exacerbation Prevention and Management of Bronchiectasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10323201/

  In the 2019 British Thoracic Society (BTS) guideline, pulmonary rehabilitation (PR) was recommended in those with functional limitation caused by breathlessness. […] The role of surgery is limited in bronchiectasis patients. Indications include patients with severe localized lesion who failed with all medical treatments, or those with severe complications, such as life-threatening hemoptysis or recurrent pneumonia. […] Mucoactive drugs have shown potential to reduce exacerbation risk in bronchiectasis patients with frequent exacerbations; however, further well-designed studies are needed. […] The current guidelines recommend the long-term use of macrolide in bronchiectasis patients with three or more exacerbations per year, primarily in those without pseudomonas colonization. […] Long-term use of macrolides is not only recommended in bronchiectasis patients, but in COPD patients with frequent exacerbation.

• #1 Intermittent prophylactic antibiotics for bronchiectasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6355939/

  Prophylactic antibiotic therapy is a cornerstone of the management of patients with bronchiectasis, its goal being to suppress bacterial infection and to break the vicious cycle of recurrent infections and exacerbations, with resultant reductions in bacterial load, inflammation, and consequent tissue destruction of the airways. […] Pooled data on the use of long-term prophylactic antibiotics administered for three or more months have demonstrated antibiotics efficacy for patients with frequent bronchiectasis exacerbations in decreasing the frequency and severity of exacerbations, increasing the time to first exacerbation and reducing symptom burden, offset by an increased adverse event profile and increased bacterial resistance. […] In clinical practice, antibiotics are most frequently used in patients with three or more exacerbations per year, in patients with chronic P. aeruginosa infection and also in patients with less frequent exacerbations who continue to have significant impairment of quality of life despite standard treatment.

• #1 Intermittent prophylactic antibiotics for bronchiectasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6355939/

  Intermittent therapy refers to the repeated prophylactic administration of courses of antibiotics with predefined duration and intervals. […] Prophylactic antibiotics may be given for regimens of at least 14 days on-treatment followed by at least 14 days off-treatment, for cycles lasting at least three months. […] The 2017 ERS (European Respiratory Society) guidelines for bronchiectasis recommended the use of long-term antibiotics for patients with three or more exacerbations per year following treatment of the underlying cause and regular airway clearance exercises. […] Given the theoretical balance between bacterial suppression and prevention of resistance, it is important to synthesise the available data on the safety and efficacy of intermittently administered antibiotic treatments in bronchiectasis to determine their impact on the prevention of exacerbations.

• #1 The efficacy of azithromycin to prevent exacerbation of non-cystic fibrosis bronchiectasis: a meta-analysis of randomized controlled studies | Journal of Cardiothoracic Surgery | Full Text

  https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-022-01882-y

  The efficacy of azithromycin to prevent exacerbation for non-cystic fibrosis bronchiectasis remains controversial. […] Azithromycin is effective to prevent exacerbation of non-cystic fibrosis bronchiectasis. […] Long-term prophylaxis with azithromycin has been reported to reduce the frequency of exacerbations and sputum volume, and improve lung function values in patients with non-cystic fibrosis bronchiectasis. […] Our meta-analysis suggested that azithromycin treatment can substantially improve free of exacerbation, reduce pulmonary exacerbations and number of pulmonary exacerbations for non-cystic-fibrosis bronchiectasis, but showed no significantly favorable impact on FEV1 or St Georges respiratory questionnaire. […] Azithromycin treatment benefits to prevent the exacerbations among patients with non-cystic fibrosis bronchiectasis.

• #1 Exacerbation Prevention and Management of Bronchiectasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10323201/

  Although there are prominent benefits in the use of long-term macrolides in bronchiectasis patients, several adverse effects should be accounted for; gastrointestinal symptoms, increased antibiotic resistance, hearing loss, and QT prolongation have been reported as possible side effects of the long-term use of the antibiotics. […] Inhaled antibiotics and macrolides are recommended in bronchiectasis patients with three or more exacerbations per the previous year, the former in those with chronic pseudomonas infection, and the latter without.

• #1 Long-term macrolide antibiotics reduce risk of exacerbations of bronchiectasis

  https://evidence.nihr.ac.uk/alert/long-term-macrolide-antibiotics-reduce-risk-of-exacerbations-of-bronchiectasis/

  Any decisions on prophylaxis will need to be made on an individual basis, considering the potential risks. These include adverse effects and the risk of antibiotic resistance and reduced susceptibility in future infections. […] Current guidelines recommend macrolides only in patients with three or more exacerbations per year and not in patients with evidence of Pseudomonas aeruginosa infection, whereas this analysis shows that even patients with infrequent exacerbation and those with Pseudomonas infections can benefit clinically. […] However, the benefit of macrolides needs to be balanced by the adverse effects of chronic macrolide therapy, including deafness in elderly patients, cardiovascular effects, drug-drug interactions and the development of antibiotic resistance.

• #1 Bronchiectasis Review

  https://www.uspharmacist.com/article/bronchiectasis-review

  Bronchiectasis is a progressive pulmonary disorder with an increasing prevalence affecting individuals of any age. Therefore, treatment is a stepwise approach focusing on reducing and preventing the frequency of exacerbations, managing airway inflammation, improving airway function by managing airway clearance, and preventing the progression of structural lung damage. The pharmacists role in managing patients with bronchiectasis includes counseling on smoking cessation, nutritional needs, proper inhaler usage, adverse events, and keeping current on vaccinations. […] The European Respiratory Society guidelines suggest offering long term treatment for adults with bronchiectasis who have three or more exacerbations per year. They suggest long-term treatment with an inhaled antibiotic for adults with bronchiectasis and chronic P aeruginosa infection; long-term treatment with macrolides (azithromycin, erythromycin) for adults with bronchiectasis and chronic P aeruginosa infection in whom an inhaled antibiotic is contraindicated, not tolerated, or not feasible; long-term treatment with macrolides (azithromycin, erythromycin) in addition to or in place of an inhaled antibiotic, for adults with bronchiectasis and chronic P aeruginosa infection who have a high exacerbation frequency despite taking an inhaled antibiotic; long-term treatment with macrolides (azithromycin, erythromycin) for adults with bronchiectasis not infected with P aeruginosa (conditional recommendation, moderate quality evidence); long-term treatment with an oral antibiotic (choice based on antibiotic susceptibility and patient tolerance) for adults with bronchiectasis not infected with P aeruginosa in whom macrolides are contraindicated, not tolerated, or ineffective; long-term treatment with an inhaled antibiotic for adults with bronchiectasis not infected with P aeruginosa in whom oral antibiotic prophylaxis is contraindicated, not tolerated, or ineffective. […] The European Respiratory Society guidelines recommend that adult patients with a new isolation of Pseudomonas be offered eradication treatment.

• #1 Exacerbation Prevention and Management of Bronchiectasis

  https://www.e-trd.org/journal/view.php?number=4822&viewtype=pubreader

  Inhaled antibiotics and macrolides are recommended in bronchiectasis patients with three or more exacerbations per the previous year, the former in those with chronic pseudomonas infection, and the latter without. However, recent evidence suggests that macrolide may have more protective effect against exacerbation than inhaled antibiotics in those with chronic pseudomonas infection; yet further studies are needed to conclude the ideal and patient-tailored therapy for bronchiectasis patients.

• #1 Impact of prophylactic and ‘rescue pack’ antibiotics on the airway microbiome in chronic lung disease | BMJ Open Respiratory Research

  https://bmjopenrespres.bmj.com/content/10/1/e001335

  Antibiotic prophylaxis was associated with significantly lower relative abundance of respiratory pathogens such as Pseudomonas aeruginosa, Moraxella catarrhalis and members of family Enterobacteriaceae in the airway microbiome, but not Haemophilus influenzae and Streptococcus pneumoniae. […] Antibiotic prophylactic therapy suppresses recognised pathogenic bacteria in the sputum of patients with chronic lung disease. […] The use of antibiotic rescue packs may be driving AMR in this cohort rather than prophylactic antibiotics. […] Reducing the rate of exacerbations has been a major aim of patient management. […] Guidelines for bronchiectasis and COPD recommend that patients have a self-management plan (SMP) in place for acute exacerbations. Within these SMPs, antibiotics are often prescribed and kept at home by patients as a rescue pack to allow for prompt start of antibiotic treatment. […] The potential impact of prescribed antibiotic rescue packs is concerning and requires review, especially in patients with frequent exacerbations who might benefit more from antibiotic prophylaxis.

• #1 Bronchiectasis; causes, treatment and prevention.

  https://www.topdoctors.co.uk/medical-articles/bronchiectasis-causes-treatment-and-prevention

  Bronchiectasis cannot be cured but further damage can be prevented. […] Management involves inhalers that dilate the bronchi and reduce inflammation, a medication called mucodyne to make the secretions thinner and easier to cough up, and chest physiotherapy (called postural drainage) to clear all the secretions. […] Patients acquiring frequent infections will be given prophylactic antibiotics, for example, Azithromycin, to take two or three times a week. […] Early identification is the best way to prevent progression of the condition. […] It is essential to ensure that these patients do daily postural drainage exercises to clear their lungs, do breathing exercises to clear the lungs and receive antibiotics promptly for any infection. […] It is recommended that patients with bronchiectasis have a supply of antibiotics at home to take as soon as they develop symptoms of a chest infection.

• #1 Management – Bronchiectasis

  https://bronchiectasis.com.au/paediatrics/medical/management

  It is recommended that all patients with bronchiectasis have regular influenza and pneumococcal vaccinations. […] Patients should always have an updated action plan provided to them after each outpatient appointment, which should include: Symptoms and management strategies including a complete list prescribed medication to be taken when well. […] A strategy when unwell including what changes to initiate in prescribed medication and physiotherapy. […] When bronchiectasis is diagnosed early and managed appropriately in children, the prognosis is excellent.

• #1 Bronchiectasis – Pulmonary Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pulmonary-disorders/bronchiectasis-and-atelectasis/bronchiectasis

  Chronic macrolide therapy (eg, oral azithromycin given once daily or 3 times a week) reduces acute exacerbations in patients with bronchiectasis, and can slow the decline in lung function in patients with CF. […] Most patients with bronchiectasis who develop influenza or SARS-CoV-2 infection should be treated with antiviral medications to prevent complications and development of severe disease. […] Underlying conditions should be treated to slow the progression of lung disease. […] Approaches that have shown promise are under investigation for treatment of bronchiectasis.

• #1 Bronchiectasis – Lung and Airway Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/lung-and-airway-disorders/bronchiectasis-and-atelectasis/bronchiectasis

  Giving the enzyme alpha-1 antitrypsin to people with alpha-1 antitrypsin deficiency may help prevent the disorder from becoming more severe. […] Avoiding toxic fumes, gases, cigarette and other smoke, and injurious dusts also helps prevent bronchiectasis or reduce its severity. […] Watching what children put in their mouth can help prevent them from inhaling foreign objects into the airways. […] Avoiding oversedation due to medication, illicit drugs, or alcohol and seeking medical care for neurologic symptoms (such as impaired consciousness) or gastrointestinal symptoms (such as difficulty in swallowing and regurgitation or coughing after eating) may help to prevent aspiration. […] Avoiding use of mineral oil or petroleum jelly in the nose may prevent accidental inhalation of these substances into the lungs.

• #1

  https://bpac.org.nz/2020/bronchiectasis.aspx

  Early diagnosis of bronchiectasis and prompt treatment of exacerbations can help prevent its progression, and may allow reversal in some cases. […] Overcrowding and socioeconomic deprivation are important contributing factors to consider in children presenting with wet cough. […] Discuss strategies to prevent recurrent infection with parents and other caregivers, e.g. handwashing, cough and sneeze hygiene, seeking medical advice for persistent wet cough and not sharing antibiotics. […] Tobacco smoke is an airway irritant that increases mucus production and impairs airway defences, increasing the risk of acute RTIs. […] It is important to ensure children are up-to-date with their childhood immunisations. […] Children at high risk of bronchiectasis should be offered annual influenza vaccination; all children aged under five years are recommended to receive vaccination, but vaccination is only funded for children who meet eligibility criteria, which includes chronic respiratory disease with impaired lung function.

• #1

  https://bpac.org.nz/2020/bronchiectasis.aspx

  Chronic wet cough is a cardinal symptom of a persistent RTI, which is a risk factor for bronchiectasis. […] The earlier bronchiectasis is diagnosed in children, the greater the opportunity to limit its progression. […] All children with suspected bronchiectasis (see below) should be referred for paediatric assessment. […] An acute exacerbation of bronchiectasis in children is defined as increased frequency or severity of wet cough for three or more days; other symptoms such as lethargy, chest pain, breathlessness, haemoptysis, fever or coughing to the point of vomiting, may also be present. […] The patient should have an action plan for managing exacerbations, which may include keeping a home supply of antibiotics. […] Ensure parents or other caregivers understand the plan and provide them with encouragement and support to engage with strategies to prevent exacerbations, e.g. warm, dry and smoke-free homes, influenza and additional pneumococcal vaccinations (funded for children with bronchiectasis), hand, cough and sneeze hygiene practices to prevent infection, regular exercise. […] All children with bronchiectasis should be reviewed by a paediatrician the frequency is determined by disease severity.

• #1 Bronchiectasis and Pneumonia tips on prevention | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/bronchiectasis-and-pneumonia-tips-on-prevention/

  I have bronchiectasis and Mac each year. I try so hard to prevent pneumonia no matter what I do. It keeps coming back year after year. Are there any tips? I feel like I’m doing everything to keep it under control […] Sadly, our respiratory conditions, especially bronchiectasis, make us prone to repeat pneumonias. Off the top of my head, I’d say to be sure to keep up with yearly vaccines, along with others such as the pneumonia vaccine, covid, RSV, shingles etc. As we age our immune system defenses decrease accordingly. Eating „right”, getting 7-8 sleep each night, and daily movement can all help improve the immune system. […] Masking in high risk areas, I believe, is also important (grocery store, airports/planes, theaters), anywhere where there are a lot of people in a small area. I tend to limit my people exposure, outside of family, in the colder months. If we meet friends for dinner we go on the early side to avoid a crowded restaurant.

• #1

  https://lptmedical.com/blogs/respiratory-resource-center/bronchiectasis-symptoms-risk-factors-and-treatment-options?srsltid=AfmBOopOXzfzjc4pMtZtTgE6lK_P5tk5IlY1DF5AmMziBJUkSkNCh8R-

  Bronchiectasis Prevention Methods […] While bronchiectasis is largely brought on by genetics, there are several lifestyle changes that you can make to reduce your chances of contracting it. […] Maintain proper hygiene, i.e. wash your hands, sanitize your home and workplace. […] Ensure you are up-to-date on annual influenza and pneumonia vaccines. […] Seek immediate treatment for lung symptoms like a chronic cough, chest pain, and chest tightness. […] Avoid harmful airborne irritants like car exhaust, fumes, and cigarette smoke. […] As with most chronic lung conditions, early prevention and diagnosis are key. The sooner you can implement these prevention techniques, the better your outcome will be.

• #1 Prevention and Management of Childhood Bronchiectasis – Aerodigestive Society

  https://aerodigestive.us/vimeo-video/prevention-and-management-of-childhood-bronchiectasis

  The pediatric aero digestive team all across the world globe can protect the lungs and prevent bronchiectasis. […] We need to talk about cough. Cough is the most common presenting symptom in a pediatric office. […] Any cough that is more than 4 weeks needs our attention and we need to work collaboratively or individually or bring these patients if we think they need more attention to the aero digestive team. […] If its lasting more than 4 weeks, we need to kind of think about it in depth. […] So this is one patient that we all work together. […] We prevented bronchiectasis. […] So this is how we as a team work together. […] If anything is compromised, the lungs seize it, but lung is a fantastic organ. It compensates very well with minimal symptoms and everybody knows those symptoms.

• #1 Prevention and Management of Childhood Bronchiectasis – Aerodigestive Society

  https://aerodigestive.us/vimeo-video/prevention-and-management-of-childhood-bronchiectasis

  So in summary, aero digestive population is at very high risk of development of bronchiectasis. […] A collaborative team, a thoughtful collaborative team can make every child feed, grow and breathe better with least amount of respiratory morbidity. […] We now know that bronchiectasis is very preventable and thats incredibly important, but its also reversible. […] The goals are to optimize lung growth, to preserve lung function, to optimize quality of life, minimize exacerbations, prevent complications, and if possible reverse that structural lung injury. […] Whenever its possible interventions to prevent or reverse bronchiectasis should be undertaken. […] The guidelines talk about the importance of early treatment in children. […] Should we be using airway clearance therapies in non-CF bronchiectasis? The answer is a resounding yes. […] It is important to have psychological and educational support. […] We should care because bronchiectasis is generally a pretty neglected lung disorder. […] Bronchiectasis carries with it a really high individual disease burden.

• #2 Exacerbation Prevention and Management of Bronchiectasis

  https://www.e-trd.org/journal/view.php?number=4822&viewtype=pubreader

  Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. […] Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. […] Good performance of ACT has been believed to improve sputum clearance and elevate the quality of life in bronchiectasis patients; however, there is a paucity of randomized controlled studies that investigate the effect of ACT on bronchiectasis patients.

• #2 Bronchiectasis – Lung and Airway Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/lung-and-airway-disorders/bronchiectasis-and-atelectasis/bronchiectasis

  Giving the enzyme alpha-1 antitrypsin to people with alpha-1 antitrypsin deficiency may help prevent the disorder from becoming more severe. […] Avoiding toxic fumes, gases, cigarette and other smoke, and injurious dusts also helps prevent bronchiectasis or reduce its severity. […] Watching what children put in their mouth can help prevent them from inhaling foreign objects into the airways. […] Avoiding oversedation due to medication, illicit drugs, or alcohol and seeking medical care for neurologic symptoms (such as impaired consciousness) or gastrointestinal symptoms (such as difficulty in swallowing and regurgitation or coughing after eating) may help to prevent aspiration. […] Avoiding use of mineral oil or petroleum jelly in the nose may prevent accidental inhalation of these substances into the lungs.

• #2 Bronchiectasis: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.bronchiectasis-care-instructions.uf9063

  If you or your child has bronchiectasis, follow directions from your doctor or respiratory therapist for moving your or your child’s body into different positions to help drain fluid. This is called postural drainage, and it helps to ease breathing and prevent infections. […] Avoid lung infections. Get shots to protect against COVID-19, the flu, and pneumococcal disease. Wash your hands frequently. Avoid illnesses such as COVID-19, colds, and the flu. […] Avoid things that can irritate your lungs. Don’t smoke or vape or allow others to do these things around you. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• #2 Bronchiectasis – Lung and Airway Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/lung-and-airway-disorders/bronchiectasis-and-atelectasis/bronchiectasis

  Early identification and treatment of conditions that tend to cause bronchiectasis may prevent its development or reduce its severity. […] Childhood immunizations against measles and pertussis (whooping cough), improved living conditions, and better nutrition have markedly reduced the number of people who develop bronchiectasis. […] Pneumococcal vaccination, COVID-19 vaccination, respiratory syncytial virus (RSV) vaccination in some people, annual influenza vaccination, and use of appropriate antibiotics early in the course of lung infections help to prevent bronchiectasis or reduce its severity. […] Other specific steps that can be taken include the following: Receiving immunoglobulin for an immunoglobulin deficiency syndrome may prevent recurring infections. […] In people who have allergic bronchopulmonary aspergillosis, using corticosteroids appropriately and sometimes an antifungal medication (such as itraconazole) may reduce the bronchial damage that results in bronchiectasis.

• #2

  https://www.nhs.uk/conditions/bronchiectasis/treatment/

  The damage to the lungs associated with bronchiectasis is permanent, but treatment can help prevent the condition getting worse. […] There are also a number of things you can do to help relieve the symptoms of bronchiectasis and stop the condition getting worse. […] These include: stopping smoking (if you smoke), having the flu vaccine every year, making sure you have had the pneumococcal vaccine to protect against pneumonia, exercising regularly, keeping yourself well hydrated, eating a balanced diet. […] If you have 3 or more infective exacerbations in any 1 year or your symptoms during an infective exacerbation were particularly severe, it may be recommended that you take antibiotics on a long-term basis. […] This can help prevent further infections and give your lungs the chance to recover.

• #2 Bronchiectasis – What You Need to Know

  https://www.drugs.com/cg/bronchiectasis.html

  Go to pulmonary rehabilitation (rehab) as directed. Pulmonary rehab is a program that can help you learn how to manage bronchiectasis and prevent exacerbations. Your plan will include aerobic exercise, such as walking, swimming, or riding a bicycle. Regular exercise helps your lungs work well and helps keep your airway clear. Rehab can help you increase your ability to exercise for as long as recommended. […] Do not smoke or be around anyone who is smoking. Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make breathing problems worse. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. […] Ask about vaccines you may need. Vaccines can help prevent some lung infections. Examples include pneumonia, pertussis (whooping cough), diphtheria, and influenza (flu). Get a flu vaccine every year as soon as recommended, usually starting in September or October. Your healthcare provider will tell you if you need other vaccines, and when to get them.

• #2 Bronchiectasis: Symptoms, Causes, Diagnosis, and Treatment

  https://www.webmd.com/lung/what-is-bronchiectasis

  Some steps help prevent the infections and tissue damage that can lead to bronchiectasis. […] Get treatment for any lung infection as soon as possible. […] If you smoke, quit. […] Make sure children get recommended vaccinations for illnesses like whooping cough and measles. […] Keep an eye on small children to keep them from putting things in their mouths. Get help right away if someone’s airways are blocked. […] Avoid things that can damage your lungs, like smoke and chemicals.

• #2 Bronchiectasis – Pulmonary Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pulmonary-disorders/bronchiectasis-and-atelectasis/bronchiectasis

  Prevention of exacerbations with regular vaccinations and sometimes suppressive antibiotics. […] The key treatment goals are to control symptoms and improve quality of life, reduce the frequency of exacerbations, and preserve lung function. […] Smoking cessation. […] Annual influenza vaccination. […] Pneumococcal vaccination. […] COVID-19 vaccination. […] Respiratory syncytial virus vaccination as clinically indicated. […] Airway clearance techniques are key components of treatment that aim to reduce chronic cough in patients with significant sputum production and mucous plugging and to reduce symptoms during exacerbations. […] Use of suppressive antibiotics regularly or on a rotating schedule reduces symptoms and exacerbations but may increase the risk that future infections will involve resistant organisms.

• #2 Bronchiectasis and Pneumonia tips on prevention | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/bronchiectasis-and-pneumonia-tips-on-prevention/

  Maybe at the top of the list should be consistent daily airway clearance. Many pulmonologists recommend twice daily 7% saline via nebulizer followed by an airway clearance routine, which may include Active Cycle of Breathing and Autogenic Drainage. […] Lastly, learn to recognize the prodrome to pneumonia. […] The key is to „catch it” before it progresses to pneumonia. Other prodromes might include fatigue, headache, malaise, lack of appetite, increased coughing, etc. […] The winter before this one, I had repeated respiratory infections despite airway clearance. This past fall, he recommended I try 7% hypertonic saline a few times a week to see if it would decrease them. […] I use 7 percent saline solution in my nebulizer.

• #2 Prevention and Management of Childhood Bronchiectasis – Aerodigestive Society

  https://aerodigestive.us/vimeo-video/prevention-and-management-of-childhood-bronchiectasis

  So in summary, aero digestive population is at very high risk of development of bronchiectasis. […] A collaborative team, a thoughtful collaborative team can make every child feed, grow and breathe better with least amount of respiratory morbidity. […] We now know that bronchiectasis is very preventable and thats incredibly important, but its also reversible. […] The goals are to optimize lung growth, to preserve lung function, to optimize quality of life, minimize exacerbations, prevent complications, and if possible reverse that structural lung injury. […] Whenever its possible interventions to prevent or reverse bronchiectasis should be undertaken. […] The guidelines talk about the importance of early treatment in children. […] Should we be using airway clearance therapies in non-CF bronchiectasis? The answer is a resounding yes. […] It is important to have psychological and educational support. […] We should care because bronchiectasis is generally a pretty neglected lung disorder. […] Bronchiectasis carries with it a really high individual disease burden.

• #2 Exacerbation Prevention and Management of Bronchiectasis

  https://www.e-trd.org/journal/view.php?number=4822&viewtype=pubreader

  The role of surgery is limited in bronchiectasis patients. Indications include patients with severe localized lesion who failed with all medical treatments, or those with severe complications, such as life-threatening hemoptysis or recurrent pneumonia. […] Mucoactive drugs have shown potential to reduce exacerbation risk in bronchiectasis patients with frequent exacerbations; however, further well-designed studies are needed. […] The current guidelines recommend the long-term use of macrolide in bronchiectasis patients with three or more exacerbations per year, primarily in those without pseudomonas colonization. […] Long-term use of macrolides is not only recommended in bronchiectasis patients, but in COPD patients with frequent exacerbation. […] Although there are prominent benefits in the use of long-term macrolides in bronchiectasis patients, several adverse effects should be accounted for; gastrointestinal symptoms (diarrhea or abdominal discomfort), increased antibiotic resistance, hearing loss, and QT prolongation have been reported as possible side effects of the long-term use of the antibiotics.

• #2 Exacerbation Prevention and Management of Bronchiectasis

  https://www.e-trd.org/journal/view.php?number=4822&viewtype=pubreader

  Inhaled antibiotics and macrolides are recommended in bronchiectasis patients with three or more exacerbations per the previous year, the former in those with chronic pseudomonas infection, and the latter without. However, recent evidence suggests that macrolide may have more protective effect against exacerbation than inhaled antibiotics in those with chronic pseudomonas infection; yet further studies are needed to conclude the ideal and patient-tailored therapy for bronchiectasis patients.

• #3 Bronchiectasis – What You Need to Know

  https://www.drugs.com/cg/bronchiectasis.html

  Go to pulmonary rehabilitation (rehab) as directed. Pulmonary rehab is a program that can help you learn how to manage bronchiectasis and prevent exacerbations. Your plan will include aerobic exercise, such as walking, swimming, or riding a bicycle. Regular exercise helps your lungs work well and helps keep your airway clear. Rehab can help you increase your ability to exercise for as long as recommended. […] Do not smoke or be around anyone who is smoking. Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make breathing problems worse. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. […] Ask about vaccines you may need. Vaccines can help prevent some lung infections. Examples include pneumonia, pertussis (whooping cough), diphtheria, and influenza (flu). Get a flu vaccine every year as soon as recommended, usually starting in September or October. Your healthcare provider will tell you if you need other vaccines, and when to get them.

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