Table 1.

Indication for Inhaled Antibiotic Treatment in Patients with Bronchiectasis and Primary Bronchial Infection (Presented in Chronological Order of Their Publication Date)

First Author Medical Society Year of Publication	Recommendations	Protocols	Inhaled Antibiotics Used	Comments
Chang, AB Thoracic Society of Australia and New Zealand Guidelines 201592	When P. aeruginosa is first detected, consider discussion with a specialist in this field regarding the suitability of eradication treatment. No recommendations for other PPMs.	No protocols.	No antibiotics listed.	No comments.
Polverino, E European Respiratory Society Guidelines 20173	Patients with a new isolation of P. aeruginosa should be offered eradication antibiotic treatment. Do not offer eradication antibiotic treatment to patients following new isolation of pathogens other than P. aeruginosa.	Three possible and alternative P. aeruginosa eradication treatment pathways based on usual clinical practice.	Colistin or tobramycin solution for inhalation or gentamicin*.	There is no clear evidence to support one regimen over another. After each step it is recommended to repeat sputum sampling and to progress to the next step if the culture remains positive.
Al-Jahdali, H Saudi Thoracic Society Guidelines 201793	No recommendation.	No protocols.	No antibiotics listed.	There is a need for more studies on the effectiveness of P. aeruginosa eradication.
Martínez-García, MA Spanish Respiratory Society Guidelines 20182	Eradication of P. aeruginosa should be attempted. Eradication of MRSA should be attempted. For other PPMs, the decision to apply an eradication treatment in initial infection should be made on an individual basis, according to the patient’s symptoms and the PPMs in question.	Several protocols for P. aeruginosa eradication. Several protocols for MRSA eradication.	Aztreonam lysine solution for inhalation, colistin or tobramycin solution for inhalation. One includes inhaled vancomycin*. Gentamicin* or any of the inhaled antibiotics used in chronic P. aeruginosa infection.	No eradication protocol has shown superiority over another.
Hill, AT British Thoracic Society Guidelines 20194	Offer eradication antibiotic treatment to patients with clinical deterioration and a new growth of P. aeruginosa. No recommendation with inhaled antibiotics for PPMs other than P. aeruginosa.	Several protocols for P. aeruginosa eradication, according to the clinical situation.	Colistin, gentamicin* or tobramycin* or tobramycin solution for inhalation.	Discuss with patients the potential risks and benefits of starting eradication treatment versus clinical observation in the context of stable bronchiectasis.
Pereira, MC Brazilian Consensus 201994	Immediately following the first identification of P. aeruginosa, the patient should be treated with a systemic antipseudomonal antibiotic combined with an inhaled antibiotic. With regard to other PPMs, there is insufficient evidence to justify the adoption of eradication protocols in this context.	Suggest a 14- to 21-day regimen of systemic antibiotic therapy in conjunction with a longer than 3-month course of inhaled antibiotic. No protocols listed.	Colistin, gentamicin* or tobramycin (solution for inhalation). No antibiotics listed.	If inhaled antibiotics are unavailable, treatment should consist only of systemic antibiotics. In selected cases, characterized by progressive functional decline and/or severe exacerbation related to the first identification of a PPMs, eradication should be undertaken.

Note: *Intravenous formulation administered via inhalation.

Abbreviations: P. aeruginosa, Pseudomonas aeruginosa; MRSA, methicillin-resistant Staphylococcus aureus; PMM, potentially pathogenic microorganisms.