Bronchiectasis is a chronic and debilitating lung disease characterized by chronic daily productive cough and recurrent chest infections caused by irreversibly damaged and dilated bronchi. The condition may be progressive and lead to respiratory failure and cor pulmonale. The management of bronchiectasis is largely empirical, with few controlled clinical trials. A recent National guideline suggests that in patients having ≥3 exacerbations per year the use of long-term antibiotic therapy should be considered. This article reviews the evidence for the use of long-term antibiotic therapy in bronchiectasis and provides a protocol for selecting eligible patients, commencing therapies, and monitoring patients during such therapy.