Combined Administration of Nebulized Amikacin in Patients With Acute Exacerbation of Non-Cystic Fibrosis Bronchiectasis

Phase 4

Completed

Brief Summary: This is a multi-centered, randomized, controlled study to assess the efficacy, indications and adverse reactions of combined administration of nebulized amikacin in patients with acute exacerbation of non-cystic fibrosis bronchiectasis and to evaluate whether inhaled antibiotics are more likely to cause bacterial resistance.

Detailed Description: Objective: To assess the efficacy, indications and adverse reactions of combined administration of nebulized amikacin in patients with acute exacerbation of non-cystic fibrosis bronchiectasis and to evaluate whether inhaled antibiotics are more likely to cause bacterial resistance.

Methods: Patients with acute exacerbation of non-cystic fibrosis bronchiectasis will be randomly assigned to the observer group (participants receive nebulized amikacin BID for 14 days in combination with standard treatment) or the control group (participants receive nebulized 0.9% saline BID for 14 days in combination with standard treatment). The primary endpoint was bacterial clearance rate of sputum.

Expected results: Compared with the control group, bacterial clearance rate of sputum of the observer Group will increase significantly.

Recruitment & Eligibility

Inclusion Criteria

Male or female study subjects ≥18 years of age and ≤80 years of age;
Confirmed diagnosis of idiopathic bronchiectasis or postinfectious bronchiectasis;
Confirmation of infection with Pseudomonas aeruginosa at screening;
Are sensitive to amikacin;
Acute exacerbation of bronchiectasis.

Exclusion Criteria

Bronchiectasis due to special causes;
Smokers;
Are associated with bronchial asthma;
Have any serious or active medical or psychiatric illness;
Be allergic to amikacin or not tolerant to nebulised amikacin(FEV1 reduces ≥15% after inhaling amikacin.

Arm && Interventions

Group	Intervention	Description
Nebulized normal saline	Normal saline	Participants received nebulized normal saline BID for 14 days in combination with standard treatment.
Nebulized amikacin	Amikacin	Participants receive nebulized amikacin BID for 14 days in combination with standard treatment.

Primary Outcome Measures

Name	Time	Method
Bacterial Clearance Rate of Sputum	after 14 days	The bacterial eradication rate of the sputum was calculated by the number of P. aeruginosa-eradicated cases according to sputum culture testing result. Sputum samples were collected in the morning after toothbrushing and gargling, before the patients used any medicine. Eligible sputum samples were defined as having ≥25 white blood cells/highpower field and ≤10 epithelial cells/high-power field; the samples were sent for testing within 60 min. Sputum samples were collected again after 14 days. If the second sputum culture test showed a negative result after the first one had been positive, it was defined as eradicated.

Secondary Outcome Measures

Name	Time	Method
Forced Expiratory Volume in One Second (FEV1) After 14 Days of Treatment	after 14 days
Total Sputum Weight (Collected Over 24 h) After 14 Days of Treatment	after 14 days
Sputum Property Score After 14 Days of Treatment	after 14 days	The sputum properties were graded from 1 to 4, with 1 being assigned to transparent mucous sputum, 2 to yellow purulent sputum, 3 to green purulent sputum, and 4 to black green purulent sputum. Higher scores mean a worse outcome.
Forced Expiratory Volume in One Second (FEV1) (Percent of Predicted for Age) After 14 Days of Treatment	after 14 days