Duration of Antibiotic Therapy in Non-cystic Fibrosis Bronchiectasis

Purpose of Review We conducted a review of the current evidence relating to antibiotic duration in the short- and long-term management of non-cystic fibrosis bronchiectasis. Recent Findings In non-cystic fibrosis pulmonary exacerbations, evidence is primarily based on expert consensus and recent guidelines recommend antibiotic durations of approximately 14 days. Chronic antibiotics (oral or inhaled) are recommended in patients with frequent exacerbations or with chronic Pseudomonas aeruginosa airways infection. Macrolides are the best studied therapies for long-term use with evidence for effect limited to a 12-month duration. Encouragingly, there are increased efforts to develop registries and conduct larger population-level studies to improve patient care. There is a paucity of evidence for optimal antibiotic strategies in exacerbations and chronic maintenance in persons with non-cystic fibrosis bronchiectasis. Rationally designed studies which utilize a registry and population-based approach will be critical to build evidence-based strategies to optimize management of non-cystic fibrosis bronchiectasis.