Abstract

Some COPD patients may not tolerate inhaled antibiotics (IA). The objective of this study was to quantify intolerance and to identify factors related to IA intolerance in COPD patients with Pseudomonas chronic bronchial infection (PCBI)

Prospective observational study of 1-year follow-up of COPD patients with PCBI who received at least one dose of IA between 2012-2020. IA intolerance was considered when adverse effects conditioned the withdrawal of IA.

79 patients were included. The Table shows the patients? characteristics according to IA tolerance. The most common symptom of intolerance was worsening dyspnea, with a mean time of appearance of 74 days. The only statistically significant difference between groups was the FEV1(%) value prior to the initiation of IA, being lower in patients who did not tolerate.

Tolerate IA
N 37 (46.8%)		 Not tolerate IA
N 42 (53.2%)

p

Characteristics
Males, %
Age, mean (SD)
Pack-year, mean(SD)
Current smokers, %
Charlson Index, mean(SD)
Daily expectoration, %
Dyspnea mMRC, mean (SD)
FEV1%, mean(SD)
Emphysema, %
Bronchiectasis, %
Eosinophils count, mean(SD)


100
74(7)
59(25)
5
6(2)
86
2,3(0,9)
49(18)
59
65
241(145)


98
77(8)
63(30)
5
5(2)
86
2,4(0,8)
43(20)
55
57
233(149)


1.000
0.184
0.656
1.000
0.396
1.000
0.501
0.028
0.156
0.155
0.790
Exacerbations previous year
Ambulatory, mean(SD)
Hospitalization, mean(SD)


3.0(1.8)
1.7(1.8)
3.6(2.4)
1.9(2.2)


0.330
0.944

Inhaled antibiotic, %
Nebulized colistin
Dry powder colistin
Nebulized tobramycin


32
0
68


33
2
64


1.000
1.000
0.945

Conclusions: Half of the patients did not tolerate IA during the first year, presenting worsening dyspnea between 2 and 3 months after beginning. Patients who did not tolerate IA presented more severe airflow obstruction.