[Inhaled antibiotics in the treatment of noncystic fibrosis bronchiectasis]

Abstract

Inhaled antibiotics are increasingly used in patients with non-cystic fibrosis (CF) bronchiectasis. Currently, there is no formal indication for the use of this therapy in these patients as inhaled antibiotics are currently only indicated in patients with CF. Therefore, prescription in patients with non-CF bronchiectasis will continue to be based on compassionate use until scientific evidence from ongoing clinical trials becomes available. However, the studies performed to date have shown several positive effects on some key parameters such as a reduction in the number of colonies and the quantity and purulence of sputum, improved quality of life and fewer exacerbations, although this therapy has little impact on accelerated loss of pulmonary function. The percentage of eradication varies, with a low rate of resistance. The clearest use of inhaled antibiotics in patients with non-CF bronchiectasis is probably colonization, especially chronic infection with Pseudomonas aeruginosa. Adverse effects are usually mild and consist of local irritation of the airway, although their frequency is greater than that in patients with CF. Currently, various clinical trials are being carried out that aim to establish the indications for inhaled antibiotic therapy in these patients. Due to its special characteristics (high local concentrations of the drug with scarce systemic adverse effects), inhaled antibiotic therapy will undoubtedly be an excellent future option for the management of bronchiectasis, as well as of many other diseases of the airways.