[Pathophysiology and treatment of bronchectasis]

Bronchiectasis is a complex pathology which consists of some important morphopathological changes in the lumen of the bronchi that consecutively determines recurrent pulmonary infections with a diversity of germs. The repeated episodes of infection are associated with chronic colonization of the respiratory system with certain pathogen microorganisms and play an important role in the maintenance of the chronic inflammatory syndrome, as well as the decline of the pulmonary function. This chronic inflammation is represented by a series of fisiopathological changes (the raised number of neutrophiles, macrophages, alteration in the expression of pro-inflammatory cytokine and adhesion molecules). The first hand treatment of patients with infected bronchiectas is the antibiotic treatment, followed by anti-inflammatory treatment and adjuvant therapy. The use of macrolides in the long-term treatment schemes has confirmed their role in the reduction of the chronic inflammatory syndrome associated with this disease, moreover its association with the anti-inflammatory medication has significantly improve the patient's health status.