Exacerbations in non-cystic fibrosis bronchiectasis

Infectious exacerbations are a major cause of respiratory morbidity in non-cystic fibrosis bronchiectasis. It remains uncertain that the outcome of an exacerbation is influenced by the involved pathogen. Although management of infectious exacerbation is currently well codified, it remains difficult and strongly influences the prognosis of the disease. The aim of our study is to determine the bacteriological profile of exacerbations in bronchiectasis through a retrospective report of 69 patients followed for bronchiectasis. All are male 51.91 years (15 to 88 years) mean aged. The average number of infectious exacerbations was 1.78 per year (0.18 to 9.09). Average of infectious exacerbations requiring hospitalization was 0.94 per year (0 to 6.25). Infection was poly-microbial in 44.9 % of cases whereas Pseudomonas aeruginosa represented 15.9 % of cases. The average number of infectious exacerbations per year increased after the first Pseudomonas aeruginosa infection occurrence in (0.52 vs 1.96). Inhaled corticosteroids and long-acting bronchodilators combination compared to inhaled corticosteroids and theophylline association seems to reduce the number of infectious exacerbations per year and of hospitalizations per year (1.45 vs 2.19) (0.76 vs 1.12) respectively (p>0.05). Conclusion: the occurrence of infectious exacerbations caused by Pseudomonas aeruginosa is a turning point in the course of bronchiectasis and requires a rigorous therapeutic strategy. Further studies are needed to better clarify the role of long-acting bronchodilators in the treatment of patients with bronchiectasis.