Introduction:

Intravenous meropenem is commonly used to treat Pseudomonas aeruginosa. To our knowledge, no study has looked at efficacy and tolerability of nebulised meropenem for prevention of exacerbations of bronchiectasis.

Aim:

To examine efficacy and tolerability of nebulised meropenem for prevention of bronchiectasis exacerbation.

Methods:

We retrospectively reviewed clinical data of bronchiectasis patients in our center who were commenced on meropenem nebulisers (Dose 250mg x BD) between 2011 to 2021.

Data was collected on exacerbations, hospital admissions and sputum culture for the twelve months before and 12 months after starting meropenem nebulisers.

Results:

95 patients were included in final analysis. The mean age of the patients was 59.88± 16.56.

Meropenem nebulisers were initiated due to multiple or frequent exacerbations, intolerance to other antibiotics, failure of alternative prophylaxis and/ or persistent positive cultures for Pseudomonas aeruginosa

The mean number of total exacerbations per year was reduced by 3.4 (p<0.001), following the initiation of meropenem nebulisers. This translates to a reduction in the mean number of exacerbations requiring oral antibiotics, intravenous antibiotics, and hospital admission of 1.064, 1.516 and 0.859 respectively (p<0.001).

Furthermore, the odds of having negative microscopy for Pseudomonas aeruginosa was 5.146 times less after starting meropenem nebulisers as compared to before starting meropenem nebulisers.

73.7% of patients showed no side effects. 26.3% of patients showed minor side effects.

Conclusion:

Nebulised meropenem is a safe and effective treatment option for prevention of bronchiectasis exacerbation and should be tested as part of RCT.