Table 2 Summary of inhaled antibiotic regimes in COPD
Antibiotic | Author and year | Dosing and duration | Study design and population | Study results |
|---|---|---|---|---|
Tobramycin | Del Negro et al. 2008 [53] | 300 mg BD via nebuliser for 14 days Follow up 6 months | Prospective Auto-control cohort study N = 13 Severe COPD and colonized with multi drug resistant P aeruginosa | Reduction in interleukin-1B, IL-8 and eosinophils P aeruginosa density lower 42% reduction in exacerbations |
Colistin | Bruguera-Avila et al 2017 [54] | 1 ml BD via nebuliser for at least 3 months Follow up 12 months | Prospective auto-control cohort study N = 36 with COPD and Pa colonisation | Reduction in admissions Reduced Length of stay for hospitalisations |
Colistin and continuous cyclic azithromycin | Montoin et al 2019 [55] | Colistin either 1–2 million IU BD or 0.5–1 million IU BD depending on drug and nebuliser device Minimum 3 months Azithromycin 500 mg three times weekly PO Follow up 2 years | Retrospective cohort study N = 32 COPD with Pa chronic bronchial infection | Reduction in exacerbations COPD by 38% Pa eradication of 28% at 2 years |
Levofloxacin | Sethi et al 2012 [56] | 240 mg BD via nebuliser for 5 out of every 28 days for 9–12 cycles | Double-blind randomised placebo-controlled trial N = 322 COPD with recurrent exacerbations randomised 2:1 ratio intervention:placebo | No difference in exacerbation rate or time to exacerbations |