Ivan Barone

Introduction Bronchiectasis is a chronic respiratory condition characterised by abnormal and persistent dilation of the bronchi, accompanied by symptoms such as chronic cough, sputum production and a history of exacerbations [1]. Recent epidemiological studies have revealed an average prevalence ranging from 701 to 1200 per 100 000 population, with rates increasing with age [2–5]. The mean age of bronchiectasis patients typically falls between 60 and 70 years in European and American studies [6].

Treatment with low-dose azithromycin is beneficial in pwCF and chronic P. aeruginosa mainly due to its immunomodulatory and anti-inflammatory properties [106]. The efficacy of macrolides does not appear to derive from the antibiotic effect but is mediated by inhibiting biofilm formation and other bacterial virulence factors. This results in improved lung function and reduced exacerbation rates in this group of patients [107]. Macrolides are also a key drug in the clinical management of NTM-PD.