Bronchiectasis Treatment: Your Complete Guide
Health ConditionsLung & Respiratory

Bronchiectasis Treatment: Medication, Airway Clearance, Lifestyle Changes, and More

Bronchiectasis Treatment: Medication, Airway Clearance, Lifestyle Changes, and More
Everyday Health
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Updated on March 3, 2026
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If you have bronchiectasis, the essential goal of treatment is to keep your airway clear.

Bronchiectasis is a chronic lung condition in which the airways become widened and damaged, making it harder to clear mucus and leading to an environment in which bacteria can grow.

 An effective treatment plan helps remove mucus, reduce infections, and protect your lungs from further damage.

Because bronchiectasis affects everyone differently, your healthcare provider will personalize your care plan based on your needs, often combining airway clearance techniques with medication and lifestyle adjustments that support easier breathing. Always talk with your doctor before starting or changing treatment for bronchiectasis.

Airway Clearance

Clearing your airway of mucus is the heart of bronchiectasis treatment. When done regularly and correctly, it can help with these concerns:

  • Lower your risk of infection
  • Make breathing easier
  • Minimize hospital visits
  • Reduce flare-ups
  • Slow or prevent disease progression

“Making sure you’re clearing the mucus that’s in the lung is what reduces the risk of recurrence of infections,” says Virginia-based Amit “Bobby” Mahajan, MD, the national medical spokesperson for the American Lung Association and system chief of interventional pulmonology at Inova Health System.

Active Cycle of Breathing Technique

Active cycle of breathing technique (ACBT) is one of the best ways to help clear mucus from your lungs, and it is a daily ritual for many people with bronchiectasis. It’s simple, flexible, and doesn’t require any special equipment.

ACBT works by moving mucus from the lower parts of your lungs up to your throat so you can expel it more easily. It uses three repeating steps: breath control (slow, relaxed belly breathing to keep airways open), deep breathing (slow, deep breaths with a brief pause to loosen mucus), and huffing (a strong exhale with an open mouth, as if you’re fogging a mirror, to move mucus upward).

Most people with bronchiectasis perform ACBT once or twice a day when they’re in stable condition. During flare-ups, it may be done more often. Each session usually lasts 10 to 30 minutes. Research shows that ACBT can clear mucus as well as many airway clearance devices, with regular use linked to better breathing and fewer flare-ups.

Airway Clearance Devices

If breathing exercises aren’t enough to clear mucus, mechanical devices can help loosen and move it so you can expel it more easily. Many people with bronchiectasis use devices along with breathing techniques as part of their daily routine.

Oscillating positive expiratory pressure (OPEP) devices are small, handheld devices resembling a pickle that you exhale through to get mucus moving, says Dr. Mahajan. They work by creating both gentle resistance and tiny vibrations that thin mucus and push it upward, effectively reducing both symptoms and flare-ups.

High-frequency chest wall oscillation, commonly called “the vest,” is a wearable wrap that vibrates rapidly to compress and release your chest gently. The movement it creates helps move thick mucus from deep, narrow airways into larger spaces from where it can be expelled. It’s an ideal choice for people with bronchiectasis who find manual breathing exercises or handheld tools too exhausting. Consistent use is shown to reduce flare-ups, reduce the need for antibiotics, and help prevent hospital stays related to the lung condition.

Positive expiratory pressure (PEP) devices use a mask or mouthpiece to create gentle back pressure while you exhale. The pressure helps hold your airway open so air can get behind the mucus, making it much easier to expel. Research shows that PEP therapy is just as effective as other clearance methods at maintaining lung function and improving quality of life, provided it’s used regularly.

Intrapulmonary percussive ventilation (IPV) uses a small machine to deliver a fine mist, sometimes with medication, along with gentle, rapid pulses of air to the lungs. These pulses create vibrations inside the airway that help move mucus so that it’s easier to expel.

Physiotherapy and Manual Techniques

The European Respiratory Society's clinical practice guidelines strongly recommend involving a physiotherapist who is experienced in bronchiectasis in your care plan.

 They can help jump-start your routine using intensive, hands-on mechanical force techniques, as well as advise on the best airway clearance techniques for improving mucus removal and reducing symptoms.
Chest physical therapy (CPT) involves the therapist using cupped hands to clap on your back and chest to help loosen mucus from the lungs so it can be expelled. They can also advise you on electronic chest clappers or vests that you can use to perform CPT at home.

Postural drainage is a technique that involves laying in specific positions, sometimes with your head below your waist, to let gravity naturally drain mucus from the deeper parts of your lungs toward your throat. A physiotherapist can evaluate your lungs to help identify which areas (or lobes) are congested, then teach you the specific positions that will work best for your body.

Medications for Bronchiectasis

To manage bronchiectasis effectively, healthcare providers use a combination of medications to keep the airways open, thin mucus secretions, fight infection, and control the chronic inflammation that leads to lung damage.

Medications for Symptom Relief

These medications make it easier to breathe and ensure that mucus is thin enough to be expelled through your daily airway clearance routine.

Bronchodilators such as albuterol (ProAir HFA, Proventil HFA, and Ventolin HFA) and levalbuterol (Xopenex, Xopenex HFA) relax the muscles surrounding your airway. By widening the bronchial tubes, they improve airflow and help sweep mucus up the respiratory tract. They are often taken 15 to 30 minutes before your airway clearance routine.

Mucoactive agents (mucolytics) help make mucus thinner and easier to expel. They’re commonly used in a nebulizer (a medical device that converts liquid medication into a fine, inhalable mist) and prescribed when bronchiectasis symptoms aren’t well controlled with ACT alone. The following medications are mucolytics:

  • acetylcysteine (Mucomyst)
  • dornase alfa (Pulmozyme)
  • hypertonic saline (Hyper-Sal, Nebusal)

Medications for Infection Control

Most people with bronchiectasis will need regular treatment with antibiotics to fight the bacteria that thrive in trapped mucus. Antibiotics can be used to treat infections and to prevent them. Your doctor will use regular sputum cultures to ensure that the medication you’re prescribed matches the specific bacteria in your lungs. This step helps prevent antibiotic resistance, which occurs when germs learn how to survive the drugs designed to kill them. When bacteria become resistant, the medicine stops working, making future infections much harder to treat.

Oral antibiotics like amoxicillin and clavulanate (Augmentin), azithromycin (Zithromax), and clarithromycin (Biaxin) may be prescribed to target common bacteria like Streptococcus pneumoniae or Haemophilus influenzae. If your tests show a more stubborn bacteria like Pseudomonas aeruginosa, or if you have cystic fibrosis, you may need stronger options such as ciprofloxacin (Cipro) or levofloxacin (Levaquin).

Inhaled antibiotics such as amikacin (Arikayce), aztreonam (Cayston), and ciprofloxacin (Otuluna, Cetraxal) are often used to reduce the bacteria in sputum and frequency of flare-ups. While these antibiotics are common treatments, they work differently depending on the cause of your bronchiectasis. They’re most effective for people with cystic fibrosis.

Long-term macrolides such as azithromycin are a type of antibiotic that also help reduce swelling (inflammation) in the body. Long-term treatment with macrolides can reduce infections and improve quality of life in people with frequent flare-ups.

Disease-Modifying Medications

Brensocatib (Brinsupri) is the first and only approved treatment specifically for non-cystic fibrosis bronchiectasis. This medication targets the underlying inflammation that causes bronchiectasis to progress. By blocking the enzyme DPP1, this drug reduces the activity of inflammatory cells (neutrophils) that damage the lungs.

In a phase 3 trial, people taking the highest approved dose of brensocatib (25 milligrams) experienced fewer flare-ups, had more healthy days, and had a higher chance of staying flare-free for a full year.

Drug Type
What It Does
Bronchodilators

Relax the muscles surrounding the airway, widening the bronchial tubes and improving airflow

Mucolytics

Make mucus thinner and easier to expel

Oral antibiotics

Target common bacteria present in trapped mucus

Inhaled antibiotics

Reduce the bacteria in sputum and frequency of flare-ups

Long-term macrolides

Help reduce inflammation

Brensocatib

Reduces activity of inflammatory cells that damage the lungs

Surgery

Surgery is usually considered a last resort for bronchiectasis. It’s typically recommended only when lung damage is severe and limited to one area, or when serious complications don’t respond to medication and airway clearance therapy.

Lung Transplant

A lung transplant replaces one or both diseased lungs with healthy donor lungs. It’s reserved for people with end-stage respiratory failure when all other treatments have failed. In one study, about 87 percent of recipients were alive one year after transplant, and roughly 53 percent were alive after five years, suggesting that a transplant can extend life in cases of advanced disease.

Bronchial Artery Embolization

Bronchial artery embolization (BAE) is a minimally invasive emergency procedure used to stop serious lung bleeding (hemoptysis). A radiologist guides a thin tube through a blood vessel to the source of bleeding and releases tiny particles to block it.

BAE is widely accepted as the first-line treatment for life-threatening hemoptysis (coughing up blood or bloody mucus). While it’s highly effective at stopping active bleeding, its long-term success depends on the type of bronchiectasis.

Lobectomy

Lobectomy involves removing the damaged lobe of the lung when disease is severe but limited to one area.

In a 23-year study of 1,357 patients, more than 96 percent of people improved after surgery, and 61 percent became completely symptom-free. Patients had the best long-term results when the entire diseased area was removed, which helped stop the cycle of repeated infections.

Lifestyle Changes

Lifestyle changes can help protect your lung function and reduce the frequency of infections.

Infection Prevention and Hygiene

The most effective way to manage bronchiectasis is to stop infections before they start. Staying current on vaccines, including influenza (flu), pneumonia, COVID-19, and RSV, can reduce your risk of a major respiratory infection.

“Staying up to date with vaccines is important because those infections rattle the microbiome of a patient with bronchiectasis,” says Panagis Galiatsatos, MD, a national spokesperson for the American Lung Association and assistant professor at the Johns Hopkins School of Medicine in Baltimore.

Avoiding Environmental Irritants

Common triggers like tobacco smoke, cleaning chemicals, and heavy fragrances irritate your nose and cause inflammation, making mucus stickier and harder to clear.

To protect your lungs, Dr. Galiatsatos recommends monitoring the air quality index. “Anything greater than 100, I would really limit my time outdoors,” he says. Inside the home, Galiatsatos suggests changing your HVAC filters at least twice a year to keep the air as clean as possible.

Hydration

Drinking enough water is a simple way to keep mucus thin and prevent buildup. When you’re dehydrated, secretions become thick and sticky, making them much harder to clear. Do your best to keep water on hand throughout the day.

Diet and Weight Management

Eating a nutrient-rich diet helps ensure that your muscles have the support they need so you can breathe and cough effectively. Weight management is also vital. “Excess weight is always going to impair the diaphragm from fully expanding the lungs,” says Galiatsatos. On the flip side, being underweight may increase your risk of infections and reduce the muscle strength needed for breathing.

Exercise

Staying active helps the healthy parts of your lungs compensate for the areas damaged by bronchiectasis and has been found to reduce bronchiectasis flare-ups and exacerbation, says Galiatsatos. If you’re intimidated by the idea of a workout, he says that your movement can be as simple as walking, taking the stairs, carrying groceries, or just doing daily chores at a faster pace. Talk to your healthcare provider about an exercise routine that’s right for you.

Questions to Ask Your Doctor

  • Is my daily airway clearance ritual working well enough?
  • Can you refer me to a respiratory physiotherapist to ensure my airway clearance technique is correct?
  • What are the side effects of the medications you’re prescribing?
  • Would saline nebulization help thin my mucus?
  • Do I need maintenance antibiotics to prevent flare-ups?
  • Which vaccines are mandatory for me?
  • What level of cardio is safe for me?
  • Are there specific exercises that help expand my chest wall or strengthen my breathing muscles?

Pulmonary Rehabilitation

If shortness of breath makes it hard for you to stay mobile, ask your doctor for a referral for pulmonary rehabilitation. This supervised program combines exercise with breathing techniques and education to help you become more active and even decrease the need for hospital visits.

“Patients are getting regular flare-ups, so they don’t want to do activities; they don’t have the energy. And as a result, they get even more deconditioned,” says Mahajan. “We really try to get people into pulmonary rehab so they can keep their muscles strong.”

These programs are often offered in group settings, potentially providing an opportunity to seek support from others living with bronchiectasis.

Mental Health Treatment

Living with bronchiectasis can lead to mental health struggles, particularly anxiety and depression.

 “When you have a disease that could rob you of your breathing at any point in time, a lot of people live with some heightened level of anxiety,” says Galiatsatos.

Time-consuming airway clearance can also increase stress, as well as exacerbate social isolation.

If bronchiectasis is affecting your mental health, alert your healthcare provider. They can recommend support from a local mental health professional or support group.

The Takeaway

  • The primary goal of bronchiectasis treatment is to keep the airway clear. ACBT, a daily breathing technique, forms the heart of this treatment, though some people will need additional aid, including from mechanical devices.
  • Medical management often involves a combination of bronchodilators to open airways, mucolytics to thin mucus, and antibiotics or the disease-modifying drug brensocatib to control bacteria growth and inflammation.
  • Lifestyle adjustments such as staying hydrated, keeping up to date on your vaccinations, and avoiding environmental irritants like tobacco smoke are critical for reducing the frequency of flare-ups.
  • Comprehensive care may also include pulmonary rehabilitation to strengthen breathing muscles and mental health support to manage the anxiety and stress often associated with chronic lung conditions.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. What Is Bronchiectasis? National Heart, Lung, and Blood Institute. October 27, 2023.
  2. Active Cycle of Breathing Technique (ACBT). Cystic Fibrosis Foundation.
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  4. Kim SR et al. Effectiveness of the Use of an Oscillating Positive Expiratory Pressure Device in Bronchiectasis With Frequent Exacerbations: A Single-Arm Pilot Study. Frontiers in Medicine. May 12, 2023.
  5. Basavaraj A et al. Impact of High Frequency Chest Wall Oscillation on Clinical Outcomes and Healthcare Resource Utilization in Adult Patients With Non-Cystic Fibrosis Bronchiectasis in the United States: A Pre-Post Cohort Analysis. American Journal of Respiratory Critical Care Medicine. 2020.
  6. McIlwaine M et al. Using Positive Expiratory Pressure Physiotherapy to Clear the Airways of People With Cystic Fibrosis. Cochrane. November 27, 2019.
  7. How Is Bronchiectasis Treated? Bronchiectasis Info and Research.
  8. Managing Bronchiectasis in Adults. European Lung Foundation. 2025.
  9. How Is Bronchiectasis Treated? American Lung Association. January 20, 2026.
  10. Tripathi AK et al. Postural Drainage and Vibration. StatPearls. June 8, 2024.
  11. Patel P et al. Bronchodilators. StatPearls. August 4, 2025.
  12. Mucolytic. Cleveland Clinic. April 13, 2023.
  13. Antibiotic Resistance. Cleveland Clinic. October 19, 2023.
  14. Steinbach T. Bronchiectasis. Merck Manual. August 2025.
  15. Chalmers JD et al. Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis. The New England Journal of Medicine. April 23, 2025.
  16. Jung F et al. Outcomes and Survival Following Lung Transplantation in Non-Cystic Fibrosis Bronchiectasis. ERJ Open Resource. 2022.
  17. Lu G-D et al. Bronchial Artery Embolization for the Management of Frequent Hemoptysis Caused by Bronchiectasis. BMC Pulmonary Medicine. November 1, 2022.
  18. Gülhan SŞ et al. Surgical Treatment of Bronchiectasis: Our 23 Years of Experience. Turkish Journal of Thoracic and Cardiovascular Surgery. October 21, 2020.
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David Mannino, MD

Medical Reviewer

David Mannino, MD, is the chief medical officer at the COPD Foundation. He has a long history of research and engagement in respiratory health.

After completing medical training as a pulmonary care specialist, Dr. Mannino joined the Centers for Disease Control and Prevention (CDC) Air Pollution and Respiratory Health Branch. While at CDC, he helped to develop the National Asthma Program and led efforts on the Surveillance Reports that described the U.S. burden of asthma (1998) and COPD (2002).

After his retirement from CDC in 2004, Mannino joined the faculty at the University of Kentucky, where he was involved both clinically in the College of Medicine and as a teacher, researcher, and administrator in the College of Public Health. He served as professor and chair in the department of preventive medicine and environmental health from 2012 to 2017, with a joint appointment in the department of epidemiology.

In 2004, Mannino helped to launch the COPD Foundation, where he served as a board member from 2004 through 2015, chairman of the Medical and Scientific Advisory Committee from 2010 through 2015, and chief scientific officer from 2015 to 2017.

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