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Long-Term Inhaled Antibiotic Treatment in Bronchiectasis

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Bronchiectasis

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Abstract

Microbial colonisation and infection are common in bronchiectasis and are associated with increased airway inflammation, increased mucus production, exacerbations and mortality. Chronic administration of inhaled antibiotics achieves high concentrations of drug within infected airways, while minimising systemic exposure and toxicity. Long-term inhaled antibiotic treatment is well established in the care of patients with cystic fibrosis, both as a strategy for eradication of newly acquired Pseudomonas aeruginosa infection and in patients chronically infected with Pseudomonas aeruginosa. Clinical trials conducted in patients with bronchiectasis show evidence of benefit for several inhaled formulations that include colistin, tobramycin, gentamicin and ciprofloxacin. Several issues are important in transitioning medicines evaluated within clinical trials into routine clinical practice and include the cost and availability of drug formulations and nebuliser systems, as well as ensuring adherence with complex treatment regimens. Future studies may provide additional evidence of benefit and finally result in licenced indications for inhaled antibiotics in people with bronchiectasis.

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Author information

Authors and Affiliations

  1. Pulmonlogy Institute and CF Center, Carmel Medical Center, Haifa, Israel

    Michal Shteinberg

  2. Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK

    Chris Johnson & Charles Haworth

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  1. Michal Shteinberg
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  2. Chris Johnson
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  3. Charles Haworth
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Correspondence to Michal Shteinberg .

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Editors and Affiliations

  1. College of Medicine, University of Dundee , Dundee, United Kingdom

    James Chalmers

  2. Hospital Vall D’Hebron, Vall D’Hebron Research Institute (VHIR) Respiratory Disease Department, Barcelona, Spain

    Eva Polverino

  3. Department of Pathophysiology and Transplantation, University of Milan Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Stefano Aliberti

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Shteinberg, M., Johnson, C., Haworth, C. (2018). Long-Term Inhaled Antibiotic Treatment in Bronchiectasis. In: Chalmers, J., Polverino, E., Aliberti, S. (eds) Bronchiectasis. Springer, Cham. https://doi.org/10.1007/978-3-319-61452-6_16

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  • DOI: https://doi.org/10.1007/978-3-319-61452-6_16

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