BACKGROUND: No prospective study has assessed eradication treatment of early Pseudomonas aeruginosa colonisation in bronchiectasis not due to cystic fibrosis (CF). OBJECTIVES: To evaluate the efficacy of 3 months of nebulised tobramycin after a short course of intravenous antibiotics in the eradication of P. aeruginosa and its clinical consequences in non- CF bronchiectasis following initial P. aeruginosa infection. METHODS: A 15-month, single-masked, randomised study including 35 patients was conducted in a tertiary university hospital. Following the isolation of P. aeruginosa and a 14-day intravenous treatment with ceftazidime and tobramycin, patients received 300 mg nebulised tobramycin twice daily or placebo during 3 months, and were followed up for 12 months thereafter. RESULTS: The median time to recurrence of P. aeruginosa infection was higher in the tobramycin than in the placebo group (p = 0.048, log-rank test). At the end of the study 54.5% of the patients were free of P. aeruginosa in the tobramycin group and 29.4% in the placebo group. The numbers of exacerbations (p = 0.044), hospital admissions (p = 0.037) and days of hospitalisation (p = 0.034) were lower in the tobramycin than in the placebo group. A global, non-significant trend to improvement in the tobramycin group was observed in most of the other studied parameters on comparing the two groups. Bronchospasm in the tobramycin group was remarkable. CONCLUSIONS: Our study shows that 3 months of nebulised tobramycin following a short course of intravenous antibiotics may prevent bronchial infection with P. aeruginosa and has a favourable clinical impact on non-CF bronchiectasis.
RCT Entities:
BACKGROUND: No prospective study has assessed eradication treatment of early Pseudomonas aeruginosa colonisation in bronchiectasis not due to cystic fibrosis (CF). OBJECTIVES: To evaluate the efficacy of 3 months of nebulised tobramycin after a short course of intravenous antibiotics in the eradication of P. aeruginosa and its clinical consequences in non- CF bronchiectasis following initial P. aeruginosa infection. METHODS: A 15-month, single-masked, randomised study including 35 patients was conducted in a tertiary university hospital. Following the isolation of P. aeruginosa and a 14-day intravenous treatment with ceftazidime and tobramycin, patients received 300 mg nebulised tobramycin twice daily or placebo during 3 months, and were followed up for 12 months thereafter. RESULTS: The median time to recurrence of P. aeruginosa infection was higher in the tobramycin than in the placebo group (p = 0.048, log-rank test). At the end of the study 54.5% of the patients were free of P. aeruginosa in the tobramycin group and 29.4% in the placebo group. The numbers of exacerbations (p = 0.044), hospital admissions (p = 0.037) and days of hospitalisation (p = 0.034) were lower in the tobramycin than in the placebo group. A global, non-significant trend to improvement in the tobramycin group was observed in most of the other studied parameters on comparing the two groups. Bronchospasm in the tobramycin group was remarkable. CONCLUSIONS: Our study shows that 3 months of nebulised tobramycin following a short course of intravenous antibiotics may prevent bronchial infection with P. aeruginosa and has a favourable clinical impact on non-CF bronchiectasis.
Authors: Khin Hnin; Chau Nguyen; Kristin V Carson; David J Evans; Michael Greenstone; Brian J Smith Journal: Cochrane Database Syst Rev Date: 2015-08-13
Authors: Anne B Chang; Jeanette Boyd; Leanne Bell; Vikas Goyal; I Brent Masters; Zena Powell; Christine Wilson; Angela Zacharasiewicz; Efthymia Alexopoulou; Andrew Bush; James D Chalmers; Rebecca Fortescue; Adam T Hill; Bulent Karadag; Fabio Midulla; Gabrielle B McCallum; Deborah Snijders; Woo-Jung Song; Thomy Tonia; Keith Grimwood; Ahmad Kantar Journal: ERJ Open Res Date: 2021-07-19
Authors: J Raidt; J Brillault; F Brinkmann; A Jung; C Koerner-Rettberg; A Koitschev; H Linz-Keul; T Nüßlein; F C Ringshausen; J Röhmel; M Rosewich; C Werner; H Omran Journal: Pneumologie Date: 2020-09-25