Introduction: There is scarce information about the most used mucolytic drug in bronchiectasis – N-acetylcysteine (N-AC). Our objective was to analyze the effect of N-AC with respect to some outcomes in bronchiectasis
Methods: Ambispective, longitudinal, observational, multi-center (43 centers) study of a cohort of 2,461 adult patients diagnosed with bronchiectasis. Those patients treated in a stable situation with at least 600 mg/d of N-AC (368; 15%) for at least 6 months were compared with patients not receiving this treatment. The variables analyzed and compared were those available two years before and after treatment. ANCOVA analysis was used to analyze the effect of N-AC as the intergroup difference of the basal intragroup difference for each variable, adjusted for relevant covariables.
Results: The N-AC group showed a full adjusted improvement of 27% in exacerbations, 17% in hospitalizations, and 31% in total exacerbation rates compared with the no-N-AC group. Moreover, a decrease in the volume of sputum production of 59.7% was observed as well as. a decrease of 12% of patients with bronchial infection by PA. The use of 1,200 mg/d (n=116) resulted in only a mild, albeit improvement in the exacerbation rate compared with the use of 600 mg/d (11% higher). Both doses were well tolerated.
Conclusion: N-AC (in most cases at a dose of 600 mg/d) is safe and effective and sufficient to reduce both the number of exacerbations and hospitalizations and the purulence and volume of sputum, as well as the isolation rate of PA. in patients with bronchiectasis
