Inhaled antibiotic treatment reduces the frequency of infective exacerbations in bronchiectasis: a single center, real life study

Background: Bronchiectasis is a chronic inflammatory disease characterized by recurrent bacterial infections associated with cough, sputum production, impaired quality of life and increased mortality. In patients with chronic Pseudomonas infection, the use of long term inhaled antibiotics is recommended, although evidence for their efficacy is low- grade. Objectives: To investigate the effect of inhaled antibiotic treatment on exacerbation frequency and lung function in patients with bronchiectasis. Methods: We retrospectively collected data on patients with bronchiectasis who commenced treatment with inhaled antibiotics in a single bronchiectasis center between 2013 and 2018. Data including demographic parameters, lung function, sputum bacteria, and exacerbations were extracted from medical reports including hospital and outpatient clinics. For every patient, a comparison was made between the year prior to commencing inhaled antibiotic treatment to the time during treatment. Results: Thirty eight patients (13 men and 25 women) had complete data and fulfilled all the inclusion criteria. The mean age was 71.3 (range, 23-89). Following inhaled antibiotic treatment, there was a significant reduction in the frequency of exacerbations from 1.42 per year to 1 per year, P=0.001 (figure 1). Lung function did not change: FEV1 values before and during treatment were 60.1% and 60.4%, respectively (p= 0.747.) Conclusions: Treatment with inhaled antibiotics is associated with a reduction in the frequency of exacerbations in patients with bronchiectasis but no effect on lung function tests.