The efficacy of inhaled antibiotics in non-cystic fibrosis bronchiectasis

Introduction: Non-cystic fibrosis bronchiectasis (NCFB) is considered a chronic heterogenic pulmonary disease, characterized by the permanent and abnormal enlargement and thickening of bronchial walls, impaired mucociliary clearance, and suppuration. Inhaled antibiotics have been used for a long time in patients with cystic fibrosis but are seldom used in those with NCFB and few randomized clinical trials are available in this population. Areas covered: This review summarizes current clinical evidence of efficacy, adverse events, and future directions of inhaled antibiotics in NCFB. Expert commentary: Inhaled antibiotics are theoretically a promising therapeutic option for patients with NCFB, owing to the achieved high pulmonary concentrations and the irrelevant systemic adverse effects. In the era of multidrug resistance, we call for comprehensive clinical trials in this field to corroborate the merits of inhaled antibiotics in NCFB patients.