Bronchiectasis: the arrival of better evidence

Abstract

Bronchiectasis unrelated to cystic fibrosis is increasingly recognised as a major contributor to respiratory morbidity and mortality in children and adults living in countries of all income levels.1,2 Despite its importance, bronchiectasis has attracted little research. As a result, the management of bronchiectasis is often extrapolated from research on cystic fibrosis.1,2 However, this extrapolation might have unintended consequences. For example, recombinant human DNase, a mucolytic agent used successfully in cystic fibrosis, leads instead to increased exacerbations and hospital admissions, and accelerated pulmonary decline in adult patients with bronchiectasis.