What is the role of aerosolized antibiotics in the treatment of bronchiectasis?

Updated: Jul 23, 2019
  • Author: Ethan E Emmons, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

In the past several years, the nebulized route of antibiotic administration has received more attention because it is capable of delivering relatively high concentrations of drugs locally with relatively few systemic adverse effects. [91] This is particularly beneficial in treating patients with chronic infection from P aeruginosa. Currently, inhaled tobramycin is the most widely used nebulized treatment for patients with bronchiectasis from either CF or non-CF causes of bronchiectasis. [92, 93, 94, 95, 96] Gentamicin [97] and colistin [98] have also been used.

No significant studies have examined the long-term use of inhaled antibiotics in patients with non-CF bronchiectasis. A study by Govan et al found sustained long-term benefit (12 mo) of inhaled gentamicin in this subgroup, along with an acceptable side effect profile. [99] Optimal dosing regimen of inhaled gentamicin still needs to be elucidated.


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