Prevention and treatment of exacerbations are vital for the effective management of bronchiectasis. There is a lack of clinical trials to help guide clinicians with regard to evidence-based interventions for patients with bronchiectasis. Recent clinical trial evidence supports the use of long-term oral macrolide therapy to prevent exacerbations in patients with and without chronic Pseudomonas infection. There is less robust evidence for therapies used to treat exacerbations in bronchiectasis, and for other therapies that aim to prevent exacerbations, including inhaled antibiotics. As a result, clinical practice varies significantly among clinicians. The development of large international databases should increase the evidence base for interventions. International guidelines are due to be published in 2017 that will update best-practice management of patients with bronchiectasis.

Cite as: Harrison MJ, Haworth CS. Non-cystic fibrosis bronchiectasis: treatment and prevention of pulmonary exacerbations. In: Burgel P-R, Contoli M, López-Campos JL, eds. Acute Exacerbations of Pulmonary Diseases (ERS Monograph). Sheffield, European Respiratory Society, 2017; pp. 181–198 [https://doi.org/10.1183/2312508X.10016716].