Inhaled Tobramycin in Non–Cystic Fibrosis Patients with Bronchiectasis and Chronic Bronchial Infection with

In patients with cystic fibrosis (CF), chronic bronchial infec-tion with Pseudomonas aeruginosa (PA) is associated with worsening lung function and an increase in morbidity and mortality, even though patients are receiving oral or intra-venous treatment.1 Delivery of inhaled antibiotics to the low-er airway is an accepted way of controlling these infections, since good evidence exists in support of this treatment.2 Extensive lung disease and severe bronchial obstruction appear to be present when chronic bronchial infection with PA occurs in patients with non-CF bronchiectasis.3-5 More hospital admissions4,5 and worse quality of life have also been observed in these patients more than in bronchiectatic patients infected by other bacteria.4 Furthermore, a rapid decline in lung function has been demonstrated in patients infected with PA.6 Thus, chronic PA bronchial infection in CF and non-CF patients seems to be a severe complica-tion. Clinical trials evaluating the efficacy of inhaled to-bramycin therapy in non-CF bronchiectasis and chronic bronchial infection with PA are scarce. A small open-label study involving 15 patients showed that inhaled ceftazidim