An update on pediatric bronchiectasis

ABSTRACT

Introduction: The prevalence and awareness of bronchiectasis not related to cystic fibrosis (CF) is increasing and it is now recognized as a major cause of respiratory morbidity, mortality and healthcare utilization worldwide. The need to elucidate the early origins of bronchiectasis is increasingly appreciated and has been identified as an important research priority. Current treatments for pediatric bronchiectasis are limited to antimicrobials, airway clearance techniques and vaccination. Several new drugs targeting airway inflammation are currently in development.

Areas covered: Current management of pediatric bronchiectasis, including discussion on therapeutics, non-pharmacological interventions and preventative and surveillance strategies are covered in this review. We describe selected adult and pediatric data on bronchiectasis treatments and briefly discuss emerging therapeutics in the field.

Expert commentary:

Despite the burden of disease, the number of studies evaluating potential treatments for bronchiectasis in children is extremely low and substantially disproportionate to that for CF. Research into the interactions between early life respiratory tract infections and the developing immune system in children is likely to reveal risk factors for bronchiectasis development and inform future preventative and therapeutic strategies. Tailoring interventions to childhood bronchiectasis is imperative to halt the disease in its origins and improve adult outcomes.

KEYWORDS:

• Bronchiectasis
• children
• cough
• treatment

Declaration of interest

A. Chang holds multiple grants awarded from the NHMRC related to diseases associated with pediatric cough and bronchiectasis. The views expressed in this publication are those of the authors and do not reflect the views of the NHMRC. D. Wurzel holds a current grant awarded from Murdoch Childrens Research Institute related to respiratory disease. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

A. Chang is supported by a NHMRC practitioner fellowship [grant 1058213].