Suzanne, first the diagnosis of bronchiectasis needs to be confirmed. This is usually accomplished by survey thoracic radiographs; however, CT and/or histopathology (biopsy) may be necessary to detect subtle lesions. A diagnosis of bronchiectasis warrants a thorough diagnostic workup including bronchoscopy and bronchoalveolar lavage to identify underlying/concurrent diseases.
Treatment, then, centers on reducing or eliminating the underlying cause of chronic inflammation (e.g., chronic bronchitis, infection) if present. Unfortunately, bronchiectasis is irreversible and therefore not curable (except focal disease treated by lung lobectomy). Long-term management focuses on decreasing inflammation, enhancing mucociliary celarance, and giving appropriate antimicrobials for secondary infection.
Chronic treatment may involve the following:
humidification or nebulization - enhances mucociliary function
oral glucocorticosteroids such as prednisone - please note, however, that if bronchiectasis is due to resolved pneumonia then glucocorticosteroids may not be indicated
metered-dose inhalant glucocorticosteroids - like oral glucocorticosteroids, continuation of these drugs is based on the underlying disease contributing to bronchiectasis
treat recurrent secondary bacterial infections if present, ideally based on culture and sensitivity and with an antibiotic that penetrates the blood-bronchus barrier such as a tetracycline or fluoroquinolone
please note that cough suppressants are contraindicated as they further impair mucociliary clearance and bronchodilators are unlikely to be helpful
As you can see managing these patients can be a challenge. In summary, they're treated by balancing antibiotics for secondary infections and antiinflammatory (not immunosuppressive) doses of glucocorticosteroids. Please respond with further questions or concerns if you wish.