PT  - JOURNAL ARTICLE
AU  - Rahul Bhatnagar
AU  - Nicholas Withers
TI  - Survey of microbiology, pseudomonas eradication and antimicrobial prophylaxis in adult patients with non-cystic fibrosis bronchiectasis
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2542
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2542.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2542.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: Recent guidelines on non-CF bronchiectasis advocate the use of prophylactic antibiotics in frequent exacerbators, and eradication of Pseudomonas Aeruginosa (PA) on first isolation in sputum. We examined the sputum microbiology and antimicrobial treatment in a cross-section of patients seen within our respiratory service.Methods: Data was collected on all patients seen for routine follow up of non-CF Bronchiectasis for 4 months. We analysed PA status; Prior attempts at eradication of PA; The use of prophylactic antibiotics; and sputum microbiology for the preceding 5 years.Results: 210 patients were included. The commonest bacterial isolate over the 5 years, other than PA (36%), was Haemophilus influenzae (27%). 48 had positive cultures for PA in the previous 12 months. 40 patients grew PA for more than one year's duration. Eradication had been attempted in 62% of the patients who grew PA. Regimens included Ciprofloxacin (28%), nebulised colomycin (23%), and a combination of both (26%).78 (37%) patients were on prophylactic antibiotics, with thrice weekly Azithromycin being used in 61 patients. 47% had been positive for PA at some point. Data for annual exacerbation rates was not available.Conclusions: PA was cultured in just over a third of patients, with approximately two thirds of these having undergone some attempt at PA eradication using methods in line with recently published guidelines. Only 38% of those remained clear of PA for more than 1 year afterwards. Approximately 50% of patients on prophylactic antibiotics had no recent isolation of PA, although exacerbation rate data was not included in this survey.