A Randomized Controlled Trial of Nebulized Gentamicin in Non–Cystic Fibrosis Bronchiectasis

• DOI: 10.1164/rccm.201005-0756oc
• Publication Date: 2010-09-25T02:50:44Z
• Authors: Maeve P. Murray; John R. W. Govan; Catherine J. Doherty; A. John Simpson; Thomas S. Wilkinson; James D. Chalmers; Andrew P. Greening; Christopher Haslett; Adam T. Hill
• Keywords: Male; CHRONIC BRONCHIAL INFECTION; bronchiectasis; 610; TOBRAMYCIN SOLUTION; ANTIBIOTIC-THERAPY; gentamicin; Sodium Chloride; LEICESTER COUGH QUESTIONNAIRE; OBSTRUCTIVE PULMONARY-DISEASE; 03 medical and health sciences; 0302 clinical medicine; QUALITY-OF-LIFE; Surveys and Questionnaires; Administration, Inhalation; Humans; ADULT BRONCHIECTASIS; Aged; Aerosols; HEALTH-STATUS; PSEUDOMONAS-AERUGINOSA; Middle Aged; GEORGES RESPIRATORY QUESTIONNAIRE; Anti-Bacterial Agents; Bronchiectasis; Respiratory Function Tests; 3. Good health; nebulized anibiotics; Treatment Outcome; Female; Gentamicins; Follow-Up Studies

Bronchiectasis is a chronic debilitating disease with few evidence-based long-term treatments.A randomized controlled trial assessing the efficacy of nebulized gentamicin therapy over 1 year in patients non-cystic fibrosis bronchiectasis.Sixty-five were to either twice-daily gentamicin, 80 mg, or 0.9% saline, for 12 months. All reviewed at three-monthly intervals during treatment and 3 months' follow-up.At each review following assessed: quantitative qualitative sputum bacteriology; purulence 24-hour volume; FEV(1), FVC, forced expiratory flow, midexpiratory phase; exercise capacity; Leicester Cough Questionnaire St. George's Respiratory Questionnaire; exacerbation frequency. Fifty-seven completed study. At end treatment, compared saline group, group there was reduced bacterial density 30.8% eradication those infected Pseudomonas aeruginosa 92.8% other pathogens; less (8.7% vs. 38.5%; P < 0.0001); greater capacity (510 [350-690] m 415 [267.5-530] m; = 0.03); fewer exacerbations (0 [0-1] 1.5 [1-2]; 0.0001) increased time first (120 [87-161.5] d 61.5 [20.7-122.7] d; 0.02). The had improvements (81.4% 20%; 0.01) (87.5% 19.2%; 0.004) score. No differences seen volume, phase. P. isolates developed resistance gentamicin. follow-up, all outcome measures similar baseline.Regular, significant benefit bronchiectasis but needs be continuous its ongoing efficacy. Clinical registered www.clinicaltrials.gov (NCT 00749866).