Researchers at the Medical University of South Carolina recently reported on the differences between patients with non-cystic fibrosis (CF) bronchiectasis treated with or without inhaled antibiotics, and showed that treatment based on inhaled antibiotics can be successful in this patient population. The results were presented at the American College of Chest Physicians Annual Meeting (CHEST 2015), held Oct. 24–28 in Montreal, Canada, in a session of Asthma–Bronchiectasis Posters. The presentation was entitled “Characteristics of Patients With Non-CF Bronchiectasis Successfully Treated With Inhaled Antibiotics.”
Bronchiectasis is a respiratory condition characterized by a chronic inflammation of the airways that leads to irreversible dilatation and scarring. The condition can be associated with cystic fibrosis, a serious genetic disease, or associated with bacterial infections – non-CF bronchiectasis. Non-CF bronchiectasis is a common, chronic medical condition affecting around 110,000 adult individuals in the United States.
The standard of care for CF patients who suffer from bronchiectasis and chronic infection with the bacterium Pseudomonas is inhaled antibiotics. According to the authors of the study, the same clinical benefit of inhaled antibiotics has not been shown in patients with non-CF bronchiectasis.
Thus, researchers conducted a retrospective analysis comparing non-CF bronchiectasis patients under inhaled antibiotic therapy (31 patients) to patients not on inhaled antibiotics (60 patients) treated at a bronchiectasis clinic between 2006 and 2014.
They found that of the 31 patients undergoing inhaled antibiotics therapy, 6 discontinued the treatment due to: adverse side-effects (3 patients), the inability to afford the therapy (2 patients) and the apparent lack of benefit (1 patient). Statistically significant differences were found between patients under therapy with inhaled antibiotics and those without, where patients submitted to inhaled antibiotics had a higher exacerbation frequency, worse lung function (assessed through parameters such as forced vital capacity), higher presence of nodules or cysts in a chest computed tomography (CT) scan, and worse bronchiectasis severity index.
After one year of treatment with inhaled antibiotics, a significant decrease in the number of exacerbations was observed in non-CF bronchiectasis patients.
The research team concluded that inhaled antibiotics therapy is usually employed in non-CF bronchiectasis patients with a worse clinical and radiological evaluation, and that this treatment can significantly reduce the number of exacerbations related to the disease. The authors also suggest that the number of exacerbations could be considered a relevant clinical endpoint in future clinical trials assessing the safety and efficacy of inhaled antibiotics in this patient population.