by Felix C.

Describe the approach to long-term management.

Management goals are to stop or delay disease progression, reduce exacerbation frequency (goal ≤ 2 per year), achieve symptom control, and improve the patient's quality of life.


  • General measures

    • Educate the patient regarding prognosis and the use of long-term medications.

    • Promote lifestyle changes like regular exercise and smoking cessation.

    • Educate the patient on airway clearance techniques.

      • Bronchopulmonary hygiene and chest physiotherapy: e.g., cupping and clapping, postural drainage, directed cough, hydration

      • Pulmonary rehabilitation: may improve exercise capacity and respiratory symptoms

    • Administer vaccinations (i.e., seasonal influenza vaccine, pneumococcal vaccine).

    • Consider treatment with mucoactive agents, bronchodilators, or corticosteroids if airway clearance is difficult.

    • Provide specific treatment for the underlying cause if identified.

  • Disease progression

    • Consider long-term antibiotic therapy for bronchiectasis with ≥ 3 exacerbations per year.

  • Advanced disease

    • Invasive procedures: not routinely indicated

Perform a careful reassessment of patients who are progressively deteriorating (i.e., patients with increased frequency and/or severity of exacerbations, frequent hospital admissions, worsening symptoms, rapid decline in lung function). Identify the cause of bronchiectasis if still unknown, and exclude any comorbidities or exacerbating conditions such as new pathogen colonization.

For patients with bronchiectasis and chronic productive cough or difficulty expectorating, consider referral to a trained respiratory physiotherapist for airway clearance techniques.


Felix C.


Last changed