Targeted AntiBiotics for Chronic pulmonary diseases (TARGET ABC): can targeted antibiotic therapy improve the prognosis of Pseudomonas aeruginosa-infected patients with chronic pulmonary obstructive disease, non-cystic fibrosis bronchiectasis, and asthma? A multicenter, randomized, controlled, open-label trial

Trials. 2022 Sep 27;23(1):817. doi: 10.1186/s13063-022-06720-z.


Background: Pseudomonas aeruginosa infection is seen in chronic pulmonary disease and is associated with exacerbations and poor long-term prognosis. However, evidence-based guidelines for the management and treatment of P. aeruginosa infection in chronic, non-cystic fibrosis (CF) pulmonary disease are lacking. The aim of this study is to investigate whether targeted antibiotic treatment against P. aeruginosa can reduce exacerbations and mortality in patients with chronic obstructive pulmonary disease (COPD), non-CF bronchiectasis, and asthma.

Methods: This study is an ongoing multicenter, randomized, controlled, open-label trial. A total of 150 patients with COPD, non-CF bronchiectasis or asthma, and P. aeruginosa-positive lower respiratory tract samples will be randomly assigned with a 1:1 ratio to either no antibiotic treatment or anti-pseudomonal antibiotic treatment with intravenous beta-lactam and oral ciprofloxacin for 14 days. The primary outcome, analyzed with two co-primary endpoints, is (i) time to prednisolone and/or antibiotic requiring exacerbation or death, in the primary or secondary health sector, within days 20-365 from study allocation and (ii) days alive and without exacerbation within days 20-365 from the study allocation.

Discussion: This trial will determine whether targeted antibiotics can benefit future patients with chronic, non-CF pulmonary disease and P. aeruginosa infection in terms of reduced morbidity and mortality, thus optimizing therapeutic approaches in this large group of chronic patients.

Trial registration: NCT03262142 . Registered on August 25, 2017.

Keywords: Antibiotics; Asthma; Chronic obstructive pulmonary disease; Non-CF bronchiectasis; Pseudomonas aeruginosa; Randomized controlled trial.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Asthma* / complications
  • Asthma* / diagnosis
  • Asthma* / drug therapy
  • Bronchiectasis* / diagnosis
  • Bronchiectasis* / drug therapy
  • Ciprofloxacin / adverse effects
  • Fibrosis
  • Humans
  • Prednisolone / therapeutic use
  • Prognosis
  • Pseudomonas aeruginosa
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • beta-Lactams


  • Anti-Bacterial Agents
  • beta-Lactams
  • Ciprofloxacin
  • Prednisolone

Associated data