Treating and Managing Bronchiectasis

Brensocatib is the first FDA-approved medication used to treat non-cystic fibrosis bronchiectasis (NCFB) in people ages 12 and older.

Brensocatib works by targeting inflammation in the airways. It blocks an enzyme called DPP-1, which helps reduce the activity of enzymes that contribute to the ongoing airway inflammation in some people living with NCFB.

This oral medication may help reduce the risk of flare-ups, also called exacerbations.

Talk to your provider to see if this medication may be right for you, especially if you have frequent flare ups.

Antibiotics are commonly used to treat lung infections in people with bronchiectasis. They may be taken by mouth, inhaled, or, in some cases, given through a vein (intravenous). If antibiotics are recommended, your healthcare provider will need to decide on the right antibiotic treatment for you. This will be based on the type of bacteria that is causing the infection, your symptoms and any history of antibiotic resistance.

Azithromycin is a type of antibiotic that also helps with managing inflammation and may be indicated to help manage your condition. When taken as prescribed for bronchiectasis, it has been shown to help with managing symptoms and may reduce flare-ups. If you have two or more flare-ups in a year, your provider may recommend this treatment option.

Medications that help open your airways may be recommended. These include bronchodilators which relax the muscles around your airways and make breathing easier. You may also be prescribed inhaled corticosteroids, particularly if you are living with another lung condition such as asthma or COPD.

Mucus thinning medication and expectorants may be prescribed to help clear mucus from your lungs. Expectorants help loosen mucus in the lungs making it easier to cough up. Mucus thinning medications are often given through a nebulizer. Examples of these include hypertonic saline or acetylcysteine, which is turned into a mist and inhaled deep into the lungs. Good hydration is also recommended to help keep the mucus in your lungs moist and slippery. Drinking plenty of fluids, especially water, is important.

Your provider may have you use a hand-held device to help break up the mucus so you can clear the mucus by coughing it out. Examples include Oscillating Positive Expiratory Pressure (PEP) devices and Intrapulmonary Percussive Ventilation (IPV).

Chest Physical Therapy (CPT), also called chest physiotherapy, is a technique often performed by a respiratory therapist that involves clapping on the chest in a certain way to help loosen mucus from the lungs so it can be expelled. Electronic chest clappers or vests are now available to make it easier to perform CPT at home.

Airway clearance techniques use breathing exercises to help move mucus from the lungs to the upper airway in order for it to be coughed out more easily. The two techniques are called forced expiration technique (FET) and active cycle breathing (ACB).

Another technique to help clear the extra mucus is called postural drainage. This involves lying in different positions to help mucus drain from the lungs. In some positions, your chest may be lower than your abdomen to help move mucus toward the upper airway. Then, to cough up the mucus, you sit upright and use the huff cough technique.

Oxygen therapy may be recommended to raise low blood oxygen levels. 

In select cases, surgery may be considered when bronchiectasis affects only one area of the lung or when significant bleeding occurs.

You may be eligible to participate in a clinical trial. Talk with your healthcare provider to see if a clinical trial may be right for you. You can search for clinical trials through the Lung Association's Clinical Trial Registry or ClinicalTrials.gov.