[Is there a role for prophylactic antibiotic treatment with macrolides in bronchiectasis?]

Prophylactic antibiotherapy with macrolides is commonly used to prevent bronchiectasis exacerbations. Indeed, there is evidence that macrolides possess immunomodulatory and anti-inflammatory properties, which explains their possible efficacy in this condition despite the presence of resistant germs. This treatment seems to improve the clinical evolution of bronchectasis and to reduce the frequency and intensity of the exacerbations. However, available data concerning this issue is limited and remains insufficient to recommend its systematic use. Until larger studies with long-term follow up are available, the use of macrolides in bronchiectasis should be restricted to selected cases and should take into account their potential side effects.