Acute exacerbations in a person with bronchiectasis require what kind of management?

• A. Antibiotics; typically IV
• B. Antihistamines
• C. Surgical resection
• D. Physical therapy only

Answer: (A)

Managing acute bronchiectasis exacerbations centers on prompt antibiotic therapy to treat bacterial infection in chronically damaged airways. The impaired mucociliary clearance in bronchiectasis leads to mucus stasis and frequent bacterial colonization; during an acute flare, bacterial load and inflammation rise, driving increased sputum, fever, and dyspnea. Systemic antibiotics are used, and intravenous therapy is common when the patient is more ill or hospitalized to ensure adequate drug levels and effective coverage, including typical organisms like Pseudomonas in many patients. This approach shortens the duration of symptoms and reduces complications.

Antihistamines don’t address the infectious process; surgical resection is not a first-line acute management and is reserved for select localized cases; physical therapy and airway clearance techniques are helpful as adjuncts to improve mucus clearance but aren’t sufficient on their own to treat an acute infectious episode.