In many countries pneumonia vaccination (for the protection against infection of the bacteria pneumococcus), is part of the immunisation schedule for infants as well as for people with bronchiectasis. In this review, our search for randomised control trials that examined the effectiveness of pneumococcal vaccines for people with bronchiectasis revealed one randomised and one quasi-controlled trial. We conclude that, albeit the limitations of the review, adults and children (when age appropriate) with bronchiectasis should be vaccinated with the 23-valent polysaccharide pneumococcal vaccine as suggested in many national guidelines. Due to absence of data on how often the vaccine should be given, we recommend that national guidelines be followed until further evidence is available.
"There are no randomized controlled trials examining the effectiveness of influenza vaccination in patients with bronchiectasis, so no evidences for or against routine influenza vaccination59. There is limited evidence to support the use of 23-valent pneumococcal vaccination as routine management in adults and children with bronchiectasis, because a Cochrane review found only one single randomized trial that fulfilled the inclusion criteria60. It was open label and examined 167 patients with bronchiectasis61. "
[Show abstract][Hide abstract] ABSTRACT: The frequency of diagnosing bronchiectasis is increasing around the world. Cystic fibrosis is the most common inherited cause of bronchiectasis, but there is increasing recognition of significant numbers of patients with bronchiectasis from various causes. With increasing awareness of bronchiectasis, a significant number of research, concerning the causes and treatments, were published over the past few years. Investigation of the underlying cause of bronchiectasis is the most important key to effective management. The purpose of this report is to review the immunological abnormalities that cause bronchiectasis in those that the cystic fibrosis has been excluded, identify the available evidences of current management, and discuss several controversies in the treatment of this disorder.
Tuberculosis and Respiratory Diseases 11/2012; 73(5):249-57. DOI:10.4046/trd.2012.73.5.249
[Show abstract][Hide abstract] ABSTRACT: We highlight some of the main developments in the investigation and management of bronchiectasis, a condition causing susceptibility to airway infections and in more severe cases chronic bronchial suppuration.
Chronic infection with Pseudomonas aeruginosa and poor lung function adversely influence long-term prognosis. Investigation of the underlying cause of bronchiectasis leads to additional therapy in a higher proportion of patients than previously thought. Based on current data, inhaled corticosteroid cannot be recommended for routine use in patients with bronchiectasis. Nontuberculous mycobacterial infections have been associated with both aspergillus and gastrooesophageal reflux. There is new evidence supporting the practice of regular chest physiotherapy.
Despite some improvement in the evidence-based guide to management in noncystic fibrosis bronchiectasis, there remains a serious lack of randomized controlled trials directing therapy.
Current Opinion in Infectious Diseases 12/2009; 23(2):165-70. DOI:10.1097/QCO.0b013e328335af91 · 5.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Children from Indigenous populations experience more frequent, severe, and recurrent lower respiratory infections as infants and toddlers. The consequences of these infections are chronic lung disorders manifested by recurrent wheezing and chronic productive cough. These symptoms are aggravated more frequently by active and passive tobacco smoke exposure among Indigenous groups. Therapies for these symptoms, although not specific to children of Indigenous origins, are described as is the evidence for their use.
Pediatric Clinics of North America 12/2009; 56(6):1323-42. DOI:10.1016/j.pcl.2009.09.012 · 2.12 Impact Factor
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