Bacterial Load Guided Therapy for Severe Bronchiectasis Exacerbations

Summary

From the British Thoracic Guidelines1 and a PUBMED search there are no randomised controlled trials exploring optimum antibiotic duration for chest infections. The standard course of intravenous antibiotics for exacerbations of bronchiectasis is 14 days. This is a preliminary open labelled study to assess whether it is feasible to stop treatment earlier (day 8 or day 11) if the bacterial load is low or absent at days 7 or day 10 (it takes 24 hours for the results to be processed). All patients will therefore have a minimum of 7 days intravenous antibiotics. The intravenous antibiotic chosen is routinely used for exacerbations in bronchiectasis. Our hypothesis is that patients could have personalised treatment and be able to stop antibiotics when the sputum bacterial load is low (\<10\^6 colony forming units/ml (cfu/ml)).

Timeline

Start

2014-01

Primary completion

2020-02-01

Completion

2020-02-01

Publications

• Hill AR, Bedi P, Cartlidge MK, Turnbull K, Donaldson S, Clarke A, Crowe J, Campbell K, Franguylan R, Rossi AG, Hill AT. Early Exacerbation Relapse is Increased in Patients with Asthma and Bronchiectasis (a Post hoc Analysis). Lung. 2023 Feb;201(1):17-23. doi: 10.1007/s00408-023-00601-1. Epub 2023 Feb 6.
• Bedi P, Cartlidge MK, Zhang Y, Turnbull K, Donaldson S, Clarke A, Crowe J, Campbell K, Graham C, Franguylan R, Rossi AG, Hill AT. Feasibility of shortening intravenous antibiotic therapy for bronchiectasis based on bacterial load: a proof-of-concept randomised controlled trial. Eur Respir J. 2021 Dec 16;58(6):2004388. doi: 10.1183/13993003.04388-2020. Print 2021 Dec.

Drugs

Indications