Editing Bronchiectasis (section)

=== Anti-inflammatories ===
The two most commonly used classes of [[anti-inflammatory]] therapies are [[macrolide]]s and [[corticosteroid]]s.<ref name=Mc2013/>

Despite also being antibiotics, macrolides exert [[immunomodulator]]y effects on the host inflammatory response without systemic suppression of the immune system.<ref name=Mc2013/> These effects include modifying mucus production, inhibition of [[biofilm]] production, and suppression of [[inflammatory mediator]]s.<ref name=":02"/> Three large multicenter, randomized trials have shown reduced rates of exacerbations and improved cough and dyspnea with use of macrolide therapy.<ref name="auto1">{{Cite journal|last1=Polverino|first1=Eva|last2=Goeminne|first2=Pieter C.|last3=McDonnell|first3=Melissa J.|last4=Aliberti|first4=Stefano|last5=Marshall|first5=Sara E.|last6=Loebinger|first6=Michael R.|last7=Murris|first7=Marlene|last8=Cantón|first8=Rafael|last9=Torres|first9=Antoni|last10=Dimakou|first10=Katerina|last11=De Soyza|first11=Anthony|date=September 2017|title=European Respiratory Society guidelines for the management of adult bronchiectasis|journal=The European Respiratory Journal|volume=50|issue=3|pages=1700629|doi=10.1183/13993003.00629-2017 |pmid=28889110|doi-access=free}}</ref> The impact of adverse effects of macrolides such as [[gastrointestinal symptom]]s, [[hepatotoxicity]], and increased [[antimicrobial resistance]] needs ongoing review and study.<ref name=Qi2014/>

[[Inhaled corticosteroid]] therapy can reduce sputum production and decrease airway constriction over a period of time, helping prevent progression of bronchiectasis.<ref name=":3"/> Long term use of high-dose inhaled corticosteroids can lead to adverse consequences such as [[cataract]]s and [[osteoporosis]].<ref name=Mc2013/> It is not recommended for routine use in children.<ref name="HILL201122">{{cite journal|last=Hill|first=Adam T|author2=Pasteur, Mark|author3=Cornford, Charles|author4=Welham, Sally|author5=Bilton, Diana|date=1 January 2011|title=Primary care summary of the British Thoracic Society Guideline on the management of non-cystic fibrosis bronchiectasis|journal=Primary Care Respiratory Journal|volume=20|issue=2|pages=135–40|doi=10.4104/pcrj.2011.00007|pmc=6549837|pmid=21336465}}</ref> One commonly used therapy is [[beclometasone dipropionate]].<ref>{{cite journal|vauthors=Elborn JS, Johnston B, Allen F, Clarke J, McGarry J, Varghese G|year=1992|title=Inhaled steroids in patients with bronchiectasis|journal=Respir Med|volume=86|issue=2|pages=121–4|doi=10.1016/S0954-6111(06)80227-1|pmid=1615177}}</ref>