Intervention Review

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Mucolytics for bronchiectasis

  1. Mark Wilkinson1,
  2. Karnam Sugumar2,
  3. Stephen J Milan3,*,
  4. Anna Hart4,
  5. Alan Crockett5,
  6. Iain Crossingham6

Editorial Group: Cochrane Airways Group

Published Online: 2 MAY 2014

Assessed as up-to-date: 19 JUN 2013

DOI: 10.1002/14651858.CD001289.pub2

How to Cite

Wilkinson M, Sugumar K, Milan SJ, Hart A, Crockett A, Crossingham I. Mucolytics for bronchiectasis. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD001289. DOI: 10.1002/14651858.CD001289.pub2.

Author Information

  1. 1

    University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK

  2. 2

    Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust, Department of Paediatrics, Preston, UK

  3. 3

    Lancaster University, Lancaster Health Hub, Lancaster, UK

  4. 4

    Lancaster University, Lancaster Medical School, Clinical Research Hub, Lancaster, Lancashire, UK

  5. 5

    University of South Australia, School of Health Sciences, Adelaide, South Australia, Australia

  6. 6

    Royal Blackburn Hospital, Blackburn, Lancashire, UK

*Stephen J Milan, Lancaster Health Hub, Lancaster University, Lancaster, UK.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 2 MAY 2014



References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Crisafulli 2007 {published data only}
  • Crisafulli E, Coletti O, Costi S, Zanasi E, Lorenzi C, Lucic S, et al. Effectiveness of erdosteine in elderly patients with bronchiectasis and hypersecretion: a 15-day, prospective, parallel, open-label, pilot study. Clinical Therapeutics 2007;29(9):2001-9.
O'Donnell 1998 {published data only}
Olivieri 1991 {published data only}
  • Olivieri D, Ciaccia A, Marangio E, Marsico S, Todisco T, Del Vita M. Role of bromhexine in exacerbations of bronchiectasis. Double-blind randomized multicenter study versus placebo. Respiration 1991;58(3-4):117-21. [4900100000003559]
Wills 1996 {published data only}
  • Wills PJ, Wodehouse T, Corkery K, Mallon K, Wilson R, Cole PJ. Short-term recombinant human DNase in bronchiectasis. Effect on clinical state and in vitro sputum transportability. American Journal of Respiratory and Critical Care Medicine 1996;154(2 Pt 1):413-7. [4900100000005313]

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Alberto 1968 {published data only}
  • Alberto S, Colongo PG, Brusasco L, Frigerio G. [Studies of the clinical and respiratory functional effects of a mucolytic-antibiotic preparation in chronic bronchopulmonary diseases. Controlled double-blind single code studies] [Studi sugli effetti clinici e sulla funzionalità respiratoria di un preparato mucolitico-antibiotico nelle affezioni croniche broncopolmonari. Ricerca controllata doppio-cieca a codifica singola]. Minerva Medica 1968;59(53):2995-3002.
Balzano 1973 {published data only}
  • Balzano E, De Gaetani G. [D1-sobrerol in the treatment of acute and chronic bronchopulmonary phlogoses]. [Italian] [Il dl sobrerolo nel trattamento delle flogosi broncopolmonari acute e croniche]. Minerva Medica 1973;64(37):1995-2002.
Bateman 1971 {published data only}
Benjamin 1971 {published data only}
  • Benjamin C. The use and efficacy of mucolytic agents. South African Medical Journal 1971; Vol. 45, issue 34:948-52.
Bergogne 1985 {published data only}
  • Bergogne Berezin E, Berthelot G, Kafe HP, Dournovo P. Influence of a fluidifying agent (bromhexine) on the penetration of antibiotics into respiratory secretions. International Journal of Clinical Pharmacology Research 1985;5(5):341-4.
Bradley 2011 {published data only}
  • Bradley JM, Treacy K, O'Neill B, McCourt F, Green L, Gardner E, et al. A randomised double blind 13 week crossover trial of hypertonic saline (HTS) (6%) vs isotonic saline (ITS) (0.9%) in patients with bronchiectasis [Abstract]. Thorax 2011;66(Suppl 4):A49 [S106].
Cobbin 1971 {published data only}
Currie 1988 {published data only}
Daviskas 1999 {published data only}
  • Daviskas E, Anderson SD, Eberl S, Chan HK, Bautovich G, Anderson S, et al. Inhalation of dry powder mannitol improves clearance of mucus in patients with bronchiectasis. American Journal of Respiratory and Critical Care Medicine 1999;159(6):1843-8. [4900100000008890]
Fadda 2001 {published data only}
  • Fadda G. Oral neltenexine in patients with obstructive airways diseases: an open, randomised, controlled comparison versus sobrerol. Minerva Medica 2001;92(4):269-75. [4900100000011117]
Germouty 1988 {published data only}
  • Germouty J, Jirou-Najou JL. Clinical trial of ambroxol in 2 different dosage programs in 120 patients with bronchiectasis. [Portuguese]. Revista Brasileira de Clinica E Terapeutica 1988;17(1-2):33-6.
Ghiringhelli 1981 {published data only}
  • Ghiringhelli G. Feprazone plus bromhexine in treatment of flare-ups of chronic bronchopathies. [Italian]. Archivio Di Medicina Interna 1981;33(2):157-68.
Hasani 1994 {published data only}
  • Hasani A, Pavia D, Spiteri MA, Yeo CT, Agnew JE, Clarke SW, et al. Regional mucus transport following unproductive cough and forced expiration technique in patients with airways obstruction. European Respiratory Journal 1994;105(5):1420-5.
Hasani 1994A {published data only}
Itoh 1984 {published data only}
  • Itoh K, Kounou O, Morise M, Iwakura M, Misutani N, Katayama T, et al. Clinical effects of proteinase, sfericase (AI-794), on chronic bronchitis and similar diseases. International Journal of Clinical Pharmacology, Therapy, and Toxicology 1984;22(1):32-8.
Kawashima 1989 {published data only}
  • Kawashima K, Yamamoto H, Kadoya M, Kato M, Nata T, Iida E, et al. Clinical role of Branhamella catarrhalis infection in pulmonary disorders. [Japanese]. Saishin Igaku [Modern Medicine] 1989;44(6):1268-72.
Kellett 2005 {published data only}
  • Kellett F, Redfern J, Niven RM, Kellet F. Evaluation of nebulised hypertonic saline (7%) as an adjunct to physiotherapy in patients with stable bronchiectasis. Respiratory Medicine 2005;99(1):27-31.
Kossmagk 1980 {published data only}
  • Kossmagk R. Ultrasonic aerosol apparatus hire system - Therapy of chronic obstructive bronchitis and bronchiectasia. [German]. Zeitschrift Fur Erkrankungen der Atmungsorgane 1980;155(1):125-7.
Loukides 1998 {published data only}
Mareels 1983 {published data only}
  • Mareels J. A long term tolerance trial of bromhexine. Acta Therapeutica 1983;9(3):305-15.
Marthin 2007 {published data only}
  • Marthin JK, Mortensen J, Pressler T, Nielsen KG. Pulmonary radioaerosol mucociliary clearance in diagnosis of primary ciliary dyskinesia. Chest 2007;132(3):966-76. [4900100000021265]
Noone 1999 {published data only}
  • Noone PG, Bennett WD, Regnis JA, Zeman KL, Carson JL, King M, et al. Effect of aerosolized uridine-5'-triphosphate on airway clearance with cough in patients with primary ciliary dyskinesia. American Journal of Respiratory and Critical Care Medicine 1999;160(1):144-9. [4900100000006450]
Patterson 2007 {published data only}
  • Patterson JE, Hewitt O, Kent L, Bradbury I, Elborn JS, Bradley JM. Acapella versus 'usual airway clearance' during acute exacerbation in bronchiectasis: a randomized crossover trial. Chronic Respiratory Disease 2007;4(2):67-74.
Sahay 1982 {published data only}
  • Sahay JN, Chatterjee SS, Ingram DF. The effect of methyl cysteine (Visclair) in respiratory diseases. A pilot study. Clinical Trials Journal 1982;19(3):137-43.
Serisier 2013 {published data only}
  • Serisier DJ, Martin ML, McGuckin MA, Lourie R, Chen AC, Brain B, et al. Effect of long-term, low-dose erythromycin on pulmonary exacerbations among patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled trial. JAMA 2013; Vol. 309, issue 12:1260-7.
Stafanger 1988 {published data only}
  • Stafanger G, Garne S, Howitz P, Morkassel E, Koch C. The clinical effect and the effect on the ciliary motility of oral N-acetylcysteine in patients with cystic fibrosis and primary ciliary dyskinesia. The European Respiratory Journal 1988;1(2):161-7. [4900100000002512]
Tambascio 2011 {published data only}
  • Tambascio J, de Souza LT, Lisboa RM, Passarelli RDCV, de Souza HCD, Gastaldi AC. The influence of Flutter VRP1 components of mucus transport of patients with bronchiectasis. Respiratory Medicine 2011;105(9):1316-21.
Taskar 1992 {published data only}
  • Taskar VS, Sharma RR, Goswami R, John PJ, Mahashur AA. Effect of bromhexine on sputum amoxycillin levels in lower respiratory infections. Respiratory Medicine 1992;86(2):157-60. [4900100000003765]
Tsang 2003 {published data only}
  • Tsang SMH, Jones AYM, Tsang SM H, Jones AYM. Postural drainage or flutter device in conjunction with breathing and coughing compared to breathing and coughing alone in improving secretion removal and lung function in patients with acute exacerbation of bronchiectasis. A pilot study. Hong Kong Physiotherapy Journal 2003;21:29-36.
Verstraeten 1979 {published data only}
  • Verstraeten JM. Mucolytic treatment in chronic obstructive lung disease: double-blind comparative clinical trial with N-acetylcysteine, bromhexine and placebo. Acta Tuberculosea et Pneumologica Belgica 1979;70(1):71-80.
Wong 2012 {published data only}
Yalçin 2006 {published data only}

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Balsamo 2010
  • Balsamo R, Lanata L, Egan CG. Mucoactive drugs. European Respiratory Review 2010;19(116):127–33.
BTS 2010
  • Pasteur MC, Bilton D, Hill AT. BTS guideline for non-CF bronchiectasis. (accessed 15 November 2013).
Cotgreave 1987
  • Cotgreave I, Eklund A, Larsson K, Moldéus P. No penetration of orally administered N-acetylcysteine into bronchoalveolar lavage fluid. European Journal of Respiratory Diseases 1987;70(2):73-7.
Goeminne 2010
Henke 2007
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1 [updated March 2011]. The Cochrane Collaboration, 2011.
Review Manager (RevMan) [Computer program]
  • Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
Rogers 2007
Stafler 2010
  • Stafler P, Carr S. Non cystic fibrosis bronchiectasis: its diagnosis and management. Archives of Diseases in Childhood. Education and Practice Edition 2010;95:73-82.
Stockley 1995
Tomkiewicz 1995
  • Tomkiewicz RP, App EM, De Sanctis GT, Coffiner M, Maes P, Rubin BK, et al. A comparison of a new mucolytic N-acetylcysteine l-lysinate with N-acetylcysteine: airway epithelial function and mucus changes in dog. Pulmonary Pharmacology 1995;8(6):259–65.
TSANZ 2010
  • TSANZ and the Lung Foundation. Chronic suppurative lung disease and bronchiectasis in children and adults 2010. (accessed 15 November 2013).
Zafarullah 2003

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Crockett 2001
  • Crockett A, Cranston JM, Alpers JH, Latimer KM. Mucolytics for bronchiectasis. Cochrane Database of Systematic Reviews 2001, Issue 1. [DOI: 10.1002/14651858.CD001289]