Table 1

Inflammation-based algorithm

Airway inflammation
 Eosinophilic (sputum eosinophil count %>3)ICS 500 μg twice daily (beclomethasome equivalent) and prednisolone according to Siva23
 Neutrophilic (sputum neutrophil count %>61)Azithromycin 250 mg daily for 3 months
Mucus hypersecretionPositive expiratory pressure device (Acapella)
Hypertonic saline 6% twice daily, nebulised
Systemic inflammation (CRP >3 mg/litre)Simvastatin 20 mg daily for 3 months
  • If systemic inflammation and neutrophilic airway inflammation were present doxycycline was used in place of azithromycin to avoid coadministration of simvastatin and azithromycin.

  • CRP, C-reactive protein; ICS, inhaled corticosteroid.