Antibiotics to treat bronchiectasis

Bronchiectasis is a medical condition that occurs in the lungs. The disease can cause many serious complications if not treated promptly. Using antibiotics to treat bronchiectasis is the solution to help relieve symptoms quickly and effectively. Bronchodilator medications need to be used correctly and as directed by your doctor to avoid unwanted side effects.

Bronchiectasis is a persistent and irreversible increase in bronchial diameter of one or more bronchi. When bronchiectasis is often accompanied by destruction of the bronchial wall, leading to symptoms of cough with phlegm and repeated respiratory infections.
Bronchiectasis is divided into three types, including: cylindrical bronchiectasis, sacral bronchiectasis and rosary bronchiectasis. With common clinical symptoms such as:
Cough with long-lasting sputum: green or yellow purulent sputum, in some cases sputum mixed with blood. The amount of sputum during the day can be less or more, on average 10-150ml/day or more than 150ml/day. Sputum deposition has 3 layers: the top layer is foam, the middle layer is purulent mucus and the bottom layer is cloudy pus. Sputum production will increase when superinfection occurs. This is the most important symptom of the disease. Coughing up blood: often recurs many times and can last for many years. This may be the only symptom of the disease. Shortness of breath: appears late, is a sign of respiratory failure due to diffuse damage to the lungs, may have cyanosis of the lips and extremities. Fever: is a symptom of a respiratory infection, when fever often produces more sputum or changes the color of sputum. Chest pain: is an early sign of infection near the pleura or dilated bronchial sacs. In addition, less common symptoms of bronchiectasis may also appear: weight loss, anemia, fatigue, sweating.

Bronchodilators or antibiotics to treat bronchodilators are indicated for use when the symptoms of the disease appear:
Bronchial asthma Chronic obstructive pulmonary disease causes difficulty breathing for patients with Acute bronchiectasis. cause bronchial constriction Slows sinus rhythm. Medicines to treat bronchodilators in the form of sprays, inhalations, and aerosols are usually preferred first. Because they immediately relieve the symptoms of the disease, but there are few side effects. The drug will directly affect the amount of water in the airways, thereby helping to thin the sputum, making it easier for the patient to spit out.
In the treatment of bronchiectasis, immediate-acting drugs are often used for patients with severe symptoms of shortness of breath. Bronchodilator drugs must take effect early to reduce the symptoms of the disease and help the patient breathe again. In contrast, long-acting bronchodilators are used for more stable cases.

Bronchodilator drugs work to relax the smooth muscles of the bronchi, helping to increase the airway openings, thereby allowing air to move through the airways easily to other alveoli to perform gas exchange.
Commonly used regimens to treat bronchiectasis are treatment of bronchial superinfection, treatment of hemoptysis and treatment of bronchospasm.
Treatment of bronchial superinfection
Usually antibiotics are used for initial treatment by mouth or by injection depending on the severity of the patient's infection and the color of the sputum. Antibiotics commonly used to treat bronchodilator infections are 2nd generation cephalosporins, cefuroxime, and 3rd generation cephalosporins, cefotaxime and ceftazidime. Combined with Aminoglycoside antibiotic groups: Gentamycin (for 1 time intramuscular injection) or Amikacin (for 1 time intramuscular injection) or mixed for intravenous infusion with 0.9% sodium chloride. Other bronchodilator drugs can be used instead, such as: Penicillin for intravenous infusion, combined with aminoglycoside antibiotics. If beta-lactamase-producing bacteria are suspected, replace Penicillin G with Amoxicillin + Clavunalic acid or Ampicillin + Sulbactam, dose of 3-6g per day. If the patient's sputum has foul pus, then use a combination of Betalactam drugs with Metronidazole intravenous infusion in 2-3 divided doses, or use Penicillin in combination with Metronidazol and intravenous infusion. Change antibiotics based on clinical response and antibiogram results, if available. The duration of antibiotic treatment depends on the individual case, usually 1-2 weeks. For severe cases of bronchiectasis, bacteria are often resistant to antibiotics, so antibiotics are needed for a longer time. For example, a superinfection caused by Pseudomonas aeruginosa or by Staphylococcus areus, the duration of antibiotic treatment for bronchiectasis can be up to 3 weeks. Treatment of hemoptysis:
If coughing up light blood: the amount of blood coughed up < 50 ml/day, just lying down, eating liquids and taking cough suppressants is enough. If coughing up blood is moderate: the amount of blood coughed up from 50-200 ml/day, you must have a care regimen such as coughing up light blood. In addition, it must be combined with Transamin (intravenous use), so caution should be exercised in chronic respiratory failure. Antibiotics should be used in all cases of moderate or higher hemoptysis to prevent infection. If hemoptysis is severe and very severe: the amount of blood coughed up > 200 ml/day, the same care should be taken, using morphine, vasoconstrictor drugs as above. Combined with perfusion, blood transfusion to replenish circulating volume. In some cases, blood sputum aspiration, endotracheal intubation, or tracheostomy may be necessary to remove blood clots causing bronchial obstruction.

Treatment of bronchospasm
When patients have signs of shortness of breath, hear the lungs and hear rales, snoring, bronchodilator drugs can be used. Short-acting beta-2 agonists such as salbutamol (4 mg x 4 tablets/day, divided into 4 times), terbutaline (5 mg x 2-4 tablets/day, taken in 2-4 divided doses). This group of drugs should be used with caution in people with hyperthyroidism, cardiovascular disease, hypertension, arrhythmia, diabetes. A group of short-acting, fast-acting anticholinergic drugs such as ipratropium bromide nebulized 2 ml/time x 3 times/day. Care should be taken to use the drug for the following subjects: benign prostatic hyperplasia, prostate cancer. Using a combination of anticholinergic drugs in combination with beta-2 agonists: fenoterol/ipratropium, salbutamol/ipratropium: nebulizer 2 ml/time x 3 times/day. For long-acting bronchodilators such as bambuterol, it is recommended to take 1 tablet of 10mg/day. The treatment of bronchiectasis is very important and requires immediate treatment. Currently, drugs as well as antibiotics to treat bronchiectasis are fast and effective, helping to overcome the condition of the disease. However, patients still have to visit a doctor and have to have a doctor's supervision to use bronchodilator drugs. During the treatment of bronchiectasis, it is necessary to adhere to the use of drugs as prescribed by the doctor to achieve high efficiency.
Vinmec International General Hospital is a prestigious hospital for many years in the examination, diagnosis and treatment of respiratory diseases. Here, full convergence of a team of leading medical doctors, leading modern equipment and machinery in the country, comprehensive medical services. Since then, effectively supporting the process of examination, diagnosis and treatment of difficult cases, patients can completely rest assured when examining and treating at Vinmec.