Efficacy of nebulized gentamicin in acute exacerbation of bronchiectasis: a case report

Bronchiectasis is a chronic progressive disease and represents irreversible morphological changes of the bronchi as a result of inflammation, mainly caused by recurring infection. Acute exacerbation of bronchiectasis can cause potentially life-threatening respiratory complications. However, the optimal treatment remains controversial. We treated a 59-year-old woman with acute exacerbation of bronchiectasis, who complained of respiratory distress. The chest computed tomography scan showed fluid-filled swollen bronchi, suggesting a large volume of sputum. In the ICU, mechanical ventilation, drug therapy including intravenous antibiotics, and postural drainage were performed. However, they did not have sufficient clinical effect in the patient. Therefore, we administered nebulized 120 mg gentamicin every 12 hours. A reduction in purulent sputum and improved respiratory status were observed after a few days, and 34 days after commencing the administration of nebulized gentamicin, we eventually succeeded discontinuing mechanical venti-lation. On the 98th day of hospitalization, the patient was discharged. Treatment with nebulized gentamicin might be effective for patients with acute exacerbation of bronchiectasis.