Bronchiectasis, also known as non-cystic fibrosis bronchiectasis, is a condition where scarring and inflammation causes widening of the bronchioles (the smaller airways from the bronchi to the alveoli). This makes it harder for the cilia to clear mucus which builds up, increasing the risk of infection, especially with mucus trapped in the alveoli. Further scarring may then result.24,25

Bronchiectasis has no clear underlying cause in around half of cases. However, it is linked to infections such as pneumonia, whooping cough and tuberculosis, as well as inflammatory bowel diseases, immune system deficiencies, rheumatoid arthritis or a structural/functional problem with the cilia in the lungs.25

A severe allergic response to a fungus or mould such as aspergillus, gastric reflux, or blockage by an inhaled foreign object (eg a peanut) may also trigger bronchiectasis, as may long-term COPD or asthma.

Antibiotic treatment for acute exacerbations of bronchiectasis should take into account sputum culture testing for susceptibility, as well as the symptom severity and the patient’s previous treatment history. Amoxicillin, erythromycin or clarithromycin are the drugs of first choice, with co-amoxiclav, levofloxacin or ciprofloxacin alternatives. The course of antibiotics is normally 7-14 days.13

In addition, patients may be taught to use exercises and special equipment to clear mucus out of the lungs. A mucolytic or a saline nebuliser may make it easier to cough up the mucus.25