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Bronchiectases

Question
Hello,

Is it possible that existing bronchiectases heal up? Our child has bronchiectasis and after having moved to another place we have a new CF outpatient clinic. They say that regular antibiotics administration is outdated?

Best regards


Answer
Hello,

Generally speaking it will not be possible that the bronchiectases heal up. However, until the age of about 7 years there is a certain chance of a “remodelling” within the meaning of a certain back-formation since until that point of time the lung maturation is not over yet.
In the context of the treatment of the mutation G551D with Ivacaftor we learned that even at the age of 28 years and with an advanced formation of bronchiectases, a noticeable remodelling is possible.
This means that – if therapy is adjusted optimal – a certain back-formation is possible. According to my opinion the prognosis of CF is then not depending on the development of the bronchiectasia. The diagnosis bronchiectasia does not have to be a crushing one!
Requirements, though, are an effective physiotherapy/sports therapy and an effective inhalation treatment including the administration of antibiotics, if necessary. Antibiotics should always be used specifically, and not in a general way!
You can certainly discuss this very well with your CF outpatient clinic.

Best regards,
Dr. H.-E. Heuer
12.06.2015