Nebulised colistimethate sodium improves quality of life in patients with bronchiectasis colonised by pseudomonas aeruginosa

Pseudomonas aeruginosa ( P. aeruginosa ) colonisation has a negative quality of life (QoL) impact in patients with bronchiectasis. 1 To date there is little published work on the long term effects of inhaled antibiotics on QoL in this population. We conducted a randomised, double-blind, controlled study to investigate the efficacy of ≤6 months nebulised CMS in patients with non-cystic fibrosis bronchiectasis colonised by susceptible P. aeruginosa [ ISRCTN49790596 ]. Patients self-administered CMS (Promixin; 1 MIU/mL) or placebo (0.45% saline), twice daily via an I-neb AAD System. Here we report QoL results, measured with St. George’s Respiratory Questionnaire (SGRQ). SGRQ assesses QoL across 3 domains (symptoms, activity, impact) and was administered at weeks 0, 12, and 26. Patients with <80% compliance were excluded from analysis, leaving: n=54 (weeks 0 & 12); n=31 (week 26), for each arm. Total mean % SGRQ (Table 1), and mean changes from baseline per SGRQ domain (Table 2) are reported. Table 1. Mean SGRQ (%). Week 0 Week 12 Week 26 CMS 54.2 52.0 40.6 Placebo 56.3 53.7 54.4 Table 2. Mean Δ baseline (%). CMS Placebo SGRQ domain Week 12 Week 26 Week 12 Week 26 Symptoms -8.6 -22.3 -4.8 -5.8 Activity 0.2 -3.8 -3.8 -0.1 Impact -1.6 -10.1 -1.3 2.1 The significant QoL improvement with CMS, compared with placebo (p=0.018), was primarily due to significant improvements in symptoms (p=0.001) and impact (p=0.008) domains. These results indicate that patients with bronchiectasis colonised by P. aeruginosa benefit from dramatic improvements in QoL when treated with CMS delivered via the I-neb AAD System. 1. Wilson et al. Eur Respir J. 1997;10:1754-1760.