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Letter to the Editor

Editor, – May I congratulate Amy McLean on her article regarding bronchiectasis (Aust Prescr 2008;31:77-9). She gave a concise and practical approach to strategies often employed in treatment. May I also support the Editor in publishing this article, considering many of the drugs listed and regimens suggested were 'off label' and certainly not supported as subsidised medicines for these indications on the Pharmaceutical Benefits Schedule.

Unfortunately, many such prescriptions are unavailable to doctors who practise outside of major metropolitan teaching hospitals, although the novel approaches with nebulised aminoglycosides and longer term use of macrolides are certainly used by us, the 'respiratory colleagues'. There was also no mention made of colistin, which from experience is expensive to source, and intravenous gammaglobulin used monthly that has proven effective, particularly in those with subclass immunoglobulin deficiency.

Rob Campagnaro
Respiratory and General Physician
Bendigo, Vic.