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Obstructive Lung Diseases |

Characteristics of Patients With Non-CF Bronchiectasis Successfully Treated With Inhaled Antibiotics FREE TO VIEW

Tejaswi Nadig; Patrick Flume
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Medical University of South Carolina, Charleston, SC


Chest. 2015;148(4_MeetingAbstracts):668A. doi:10.1378/chest.2235540
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Abstract

SESSION TITLE: Asthma - Bronchiectasis Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Bronchiectasis (BE) is a condition often associated with chronic infection of the airways. For patients with cystic fibrosis (CF), who have BE and chronic infection with Pseudomonas (Ps), inhaled antibiotics are the standard of care. Studies of inhaled antibiotics in patients with non-CF BE have not demonstrated the same clinical benefit, yet our experience suggests otherwise. Our objective was to characterize the cohort of non-CF BE patients treated with inhaled antibiotics compared to non-CF BE patients not on inhaled antibiotics.

METHODS: This is a retrospective case series of non-CF BE patients seen in a bronchiectasis clinic between 2006 and 2014. Analysis was done using independent sample t-test and Pearson’s chi square on SPSS V-22.

RESULTS: Of the 91 patients reviewed, 31 (34%) were treated with inhaled antibiotics; 6 of the 31 discontinued therapy because of no perceived benefit (n=1), adverse side-effects (n=3) and inability to afford therapy (n=2). There was no difference between the treated and untreated group with respect to age, sex, and cause of bronchiectasis. However, there were statistically significant differences between treated vs untreated (respectively) for > exacerbations in the prior year (52% vs 12%), FVC % pred (68% vs 85%) and FEV1 % pred (54% vs 20.5%), presence of nodules (64.5% vs 41%) or cysts (22.5% vs 9%) on chest CT, and worse bronchiectasis severity index (14.5 vs 7.8). For the treated group there was a significant decrease in the number of exacerbations in the year following initiation of therapy.

CONCLUSIONS: Patients with non-CF BE that are treated with inhaled antibiotics have distinct clinical and radiological characteristics compared to untreated patients.

CLINICAL IMPLICATIONS: The above factors could be used to identify patients most likely to benefit in a clinical trial evaluating the efficacy and safety of inhaled antibiotics. In addition, inhaled antibiotic treatment significantly reduced the number of exacerbations in our study population, which could serve as a relevant clinical endpoint.

DISCLOSURE: The following authors have nothing to disclose: Tejaswi Nadig, Patrick Flume

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