Eradication Therapy against Pseudomonas aeruginosa in Non-Cystic Fibrosis Bronchiectasis

Respiration. 2015;90(4):299-305. doi: 10.1159/000438490. Epub 2015 Sep 5.


Background: No prospective study has assessed eradication treatment of early Pseudomonas aeruginosa colonisation in bronchiectasis not due to cystic fibrosis (CF).

Objectives: To evaluate the efficacy of 3 months of nebulised tobramycin after a short course of intravenous antibiotics in the eradication of P. aeruginosa and its clinical consequences in non- CF bronchiectasis following initial P. aeruginosa infection.

Methods: A 15-month, single-masked, randomised study including 35 patients was conducted in a tertiary university hospital. Following the isolation of P. aeruginosa and a 14-day intravenous treatment with ceftazidime and tobramycin, patients received 300 mg nebulised tobramycin twice daily or placebo during 3 months, and were followed up for 12 months thereafter.

Results: The median time to recurrence of P. aeruginosa infection was higher in the tobramycin than in the placebo group (p = 0.048, log-rank test). At the end of the study 54.5% of the patients were free of P. aeruginosa in the tobramycin group and 29.4% in the placebo group. The numbers of exacerbations (p = 0.044), hospital admissions (p = 0.037) and days of hospitalisation (p = 0.034) were lower in the tobramycin than in the placebo group. A global, non-significant trend to improvement in the tobramycin group was observed in most of the other studied parameters on comparing the two groups. Bronchospasm in the tobramycin group was remarkable.

Conclusions: Our study shows that 3 months of nebulised tobramycin following a short course of intravenous antibiotics may prevent bronchial infection with P. aeruginosa and has a favourable clinical impact on non-CF bronchiectasis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Administration, Intravenous
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Bronchiectasis / drug therapy*
  • Bronchiectasis / microbiology
  • Ceftazidime / administration & dosage
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Pseudomonas aeruginosa / drug effects*
  • Tobramycin / administration & dosage*


  • Anti-Bacterial Agents
  • Ceftazidime
  • Tobramycin