Bronchiectasis secondary prevention

To reduce the impact of the disease, patients should lead a healthy lifestyle, use prophylactic treatment when needed, do vaccinations, and practice physiotherapy strategies.

• Smoking cessation
• Exercise
• Maintain a healthy BMI

• National guidelines recommend that patients suffering from three or more exacerbations per year, should be considered for long-term antibiotics.^[1]
• Macrolide daily or three times weekly

• Macrolides exhibit anti-bacterial and immunomodulatory effects.^[1]

• Amoxicillin 500 mg twice daily or doxycycline 100 mg twice daily for patients who are not candidates for long-term macrolide administration

• There has been some evidence to support that the yearly influenza vaccine reduces morbidity, mortality, and healthcare costs with high-risk patients

• 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

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