Treating and Managing Bronchiectasis

Antibiotics are the most common treatment for bronchiectasis. Oral and sometimes inhaled antibiotics are used to treat most infections. An infection that does not get better with oral antibiotics may require intravenous (IV) antibiotics. If antibiotics are appropriate, your healthcare provider will need to decide the right antibiotic treatment for you. This will be based on the type of bacteria that is causing the infection, and possible bacterial resistance to certain antibiotics.

Medications that help your airways may be recommended. These include bronchodilators which relax the muscles around your airways to help open the airways and make breathing easier. Inhaled corticosteroids may be used to help treat inflammation in your airways.

Mucus thinning medication and expectorants may be prescribed to help you cough up mucus. Expectorants help loosen mucus in the lungs. Mucus thinning medications are often given through a nebulizer, where it is mixed with hypertonic saline solution, turned into a mist, and inhaled deep into the lungs. Good hydration is also recommended to help keep the mucus in your lungs moist and slippery. Drinking plenty of fluids, especially water, is important.

Your provider may have you use a hand-held device to help break up the mucus so you can clear the mucus by coughing it out. Some of these devices are Oscillating Positive Expiratory Pressure (PEP) and Intrapulmonary Percussive Ventilation (IPV). Chest Physical Therapy (CPT), or chest physiotherapy, is a technique often performed by a respiratory therapist that involves clapping on the chest in a certain way to help loosen mucus from the lungs so it can be expelled. Electronic chest clappers or vests are now available to make it easier to perform CPT at home.

There are breathing techniques that are used to move mucus to the upper airway in order for it to be coughed out. The two techniques are called forced expiration technique (FET) and active cycle breathing (ACB). Another technique to help clear the extra mucus is called postural drainage. When you use this technique, you can lie down in different positions to help clear the mucus. When you lie down with your chest lower than your abdomen, it can help drain the extra mucus. To cough up the mucus, sit upright and use the huff cough technique.

Oxygen therapy may be recommended to raise low blood oxygen levels. Surgery may be recommended in extreme situations where the bronchiectasis is isolated to a section of lung or there is excessive bleeding.

You may be eligible for clinical trials. Talk to your healthcare provider to see if a clinical trial may be right for you.  You can search for clinical trials on the Lung Association's Clinical Trial Registry or ClinicalTrials.gov.