Inhaled gentamicin in non-cystic fibrosis bronchiectasis: effects of long-term therapy.

Bronchiectasis is a disease state defined by irreducible dilations of the airways. If they occur in diseases other than cystic fibrosis they are termed non-CF bronchiectasis. The common denominator is the increased risk of recurrent infections with bacteria, such as Staphylococcus aureus or Pseudomonas aeruginosa. Such infections are difficult to eradicate with systemic antibiotics because the structural abnormalities in the bronchial wall reduce their bactericidal effect at this level. An alternative to systemic antibiotics might be represented by inhaled formulations, which can be given in much lower doses and can be more effective. Previous studies demonstrated that inhaled gentamicin can reduce bacterial load and local infection in both cystic fibrosis and non-CF bronchiectasis. The study discussed in this paper demonstrates that long-term therapy with inhaled gentamicin can eradicate the infection or reduce the bacterial load, decrease the risk of subsequent infections and improve the quality of life in patients with non-CF bronchiectasis with a minimal risk of side effects.