Inhaled antibiotics in the treatment of non-cystic fibrosis bronchiectasis: clinical and drug delivery perspectives

Sugianto, Tiffanie Daisy; Chan, Hak‐Kim

doi:10.1517/17425247.2015.1078309

Cited by 19 publications

(10 citation statements)

References 96 publications

(127 reference statements)

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“…We therefore have to use what is currently available but in a rational and cautious manner. Inhaled antibiotics for pulmonary infections seems a logical approach and is being used in some countries but exactly how, when, how much and for how long still needs to be refined [37].…”

Section: Antibioticsmentioning

confidence: 99%

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

et al. 2016

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Sepsis is a major growing global burden and a major challenge to intensive care clinicians, researchers, guideline committee members and policy makers, because of its high and increasing incidence and great pathophysiological, molecular, genetic and clinical complexity. In spite of recent progress short term mortality remains high and there is growing evidence of long term morbidity and increased long term mortality in survivors of sepsis both in developed and developing countries. Further improvement in the care of patients with sepsis will impact upon global health.In this narrative review, invited experts describe the expected challenges and progress to be made in the near future. We focus on resuscitation (fluids, vasopressors, inotropes, blood transfusion and hemodynamic targets) and infection control (antibiotics and infection biomarkers) as these areas are key, if initial management and subsequent outcomes are to be improved in patients with sepsis.

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Section: Antibioticsmentioning

confidence: 99%

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

et al. 2016

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“…The evidence base of the clinical efficacy of inhaled antibiotics in bronchiectasis is modest and conflicting and not sustained beyond 3 months. [ 151 152 153 154 155 156 ]…”

Section: Long-term Management Of Bronchiectasismentioning

confidence: 99%

“…[ 154 ] The evidence base of the clinical efficacy of eradication of P. aeruginosa in bronchiectasis is modest, not sustained and conflicting. [ 151 152 153 154 155 156 ] A Cochrane systematic review, 2011, did not come to solid conclusion regarding inhaled antibiotics due to paucity of the evidence. [ 146 ] Yang et al .…”

Section: Eradication Of Chronic Colonization With Pseudomonmentioning

confidence: 99%

The Saudi Thoracic Society guidelines for diagnosis and management of noncystic fibrosis bronchiectasis

et al. 2017

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This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources. We aim to provide clinicians with tools to standardize the diagnosis and management of bronchiectasis. This guideline targets primary care physicians, family medicine practitioners, practicing internists and respiratory physicians, and all other health-care providers involved in the care of the patients with bronchiectasis.

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“…With regard to safety issues, published studies on nebulized antibiotics have reported local adverse effects, mainly bronchospasm, cough, and wheeze [3,[8][9][10]. In addition, patients with severe hypoxaemia are at higher risk of suffering respiratory complications [7].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of adjunctive nebulized antibiotics in critically ill patients with respiratory tract infections

Leache

Aquerreta

Aldaz

et al. 2019

Eur J Clin Microbiol Infect Dis

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The purpose of the study was to analyze the effectiveness of adding nebulized antibiotics to systemic antimicrobials in critically ill patients with respiratory tract infections (pneumonia or tracheobronchitis) and the effect on renal function. A retrospective observational cohort study including critically ill patients with respiratory tract infections during a 2-year period was conducted. Intervention group included patients that received nebulized and systemic antimicrobials. Patients in the control group received only systemic antimicrobials. Clinical resolution was the primary endpoint. Secondary outcomes included change in fever, inflammatory parameters, and creatinine clearance; length of hospital stay, systemic therapy, and mechanical ventilation; hospital readmission; and mortality. Regression models were performed to estimate the effect of nebulized antibiotics on outcome variables adjusted by potential confounders. A total of 136 patients were included (93 in control group and 43 in intervention group). The intervention group had higher odds of clinical resolution (adjusted odds ratio (OR): 7.1; 95% confidence interval (95% CI): 1.2, 43.3). Nebulized antibiotic therapy was independently associated with reduction in procalcitonin (adjusted OR: 12.4; 95% CI: 1.4, 109.7). There were no significant differences in the rest of the secondary outcomes or in creatinine clearance reduction. Adding nebulized antibiotics for the management of respiratory tract infections has a positive impact on clinical resolution without increasing the risk of renal toxicity.

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Inhaled antibiotics in the treatment of non-cystic fibrosis bronchiectasis: clinical and drug delivery perspectives

Cited by 19 publications

References 96 publications

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

The Saudi Thoracic Society guidelines for diagnosis and management of noncystic fibrosis bronchiectasis

Effectiveness of adjunctive nebulized antibiotics in critically ill patients with respiratory tract infections

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