Bronchiectasis: which antibiotics to use and when?

PURPOSE OF REVIEW: In 2010, the British Thoracic Society published a guideline for the care of patients with noncystic fibrosis (non-CF) bronchiectasis; other recent clinical review articles and original scientific manuscripts have also studied the use of antibiotics in bronchiectasis. This review will summarize the current literature on the indications and options for antibiotic treatment in bronchiectasis.

RECENT FINDINGS: Since 2012, a number of manuscripts have been published that provide evidence to support the use of antibiotics in non-CF bronchiectasis, including macrolide antibiotics, inhaled aminoglycosides and inhaled fluoroquinolone therapies. However, data remain preliminary and there are phase 3 trials underway to further investigate the efficacy and safety of antibiotics in non-CF bronchiectasis.

SUMMARY: Although there are currently no U.S. Food and Drug Administration (FDA)-approved antibiotics for the treatment of patients with bronchiectasis, this review will highlight the current state of the science with regard to antibiotics that may be effective in non-CF bronchiectasis as well as highlighting those in development to treat this complex disease.