Table 2 .
Pharmacological and non-pharmacological treatments for stable bronchiectasis
| Treatment | Level of evidence | Grade of recommendation |
|---|---|---|
| Drugs | ||
| Antibiotics: | ||
| Prolonged use of oral antibiotics | 1++ | A |
| Aerosolised antibiotics | 1+ | A |
| Regular pulsed courses of intravenous antibiotics | 4 | D |
| Flu vaccination | 1− | C |
| Mucolytics: | ||
| Bromhexine* | 1+ | B |
| N-acetylcysteine | ? | ? |
| Recombinant human DNase aerosol | 1+ | A† |
| Mannitol inhalation powder | 2++ | B |
| Anti-inflammatory or immunomodulating drugs: | ||
| Oral corticosteroids | 2+ | D |
| Inhaled corticosteroids | 1+ | B |
| Oral leukotriene receptor antagonists | 4 | D |
| Indometacin or ibuprofen | 2− | D |
| Macrolides (clarithromycin) | 1+ | B |
| Flu vaccinination | 2+ | C |
| Bronchodilators: | ||
| Short acting β2 adrenergic agonists | 2+ | D |
| Long acting β2 adrenergic agonists | 4 | D |
| Short acting anticholinergics | 2+ | D |
| Long acting anticholinergics | 4 | D |
| Methylxanthines | 4 | D |
| Non-pharmacological treatments | ||
| Bronchopulmonary hygiene physical therapyw14 w15: | ||
| Forced expiratory technique‡ | 3 | D |
| Autogenic drainage‡ | 3 | D |
| Positive end expiratory pressure therapy‡ | 3 | D |
| Flutter device or RC-Cornet device‡ | 3 | D |
| Postural drainage§ | 3 | D |
| Mechanical vibration§ | 3 | D |
| Percussion§ | 3 | D |
| Intrapulmonary percussive ventilation§ | 3 | D |
| High frequency chest compression§ | 3 | D |
| Training | ||
| Exercise training with or without inspiratory muscle training‡ | 1+ | B |
| Surgery | ||
| Segmental, lobar, or lung resection | 2+ | B |
*Studied in acute exacerbations; †not recommended; ‡active participation of the patient needed; §passive techniques.
See table 3 for definitions of level of evidence and grade of recommendation.