M21 Clinical review of nebulised colomycin for pseudomonas colonisation in COPD and non-CF bronchiectasis

Introduction Colonisation with Pseudomonas aeruginosa is a complication of bronchiectasis and chronic bronchitis and is associated with more severe disease and lower quality of life. Colomycin (colistimethate sodium) has potent activity against P aeruginosa. It is licenced for nebulised treatment of pseudomonas colonisation in CF but not non-CF bronchiectasis or chronic bronchitis. In this study we demonstrate that nebulised colomycin therapy (NCT) can be an effective treatment of pseudomonas colonisation in non-CF bronchiectasis and chronic bronchitis. Method Adults with non-CF bronchiectasis or chronic bronchitis given a trial of NCT trial in the Southampton Respiratory Centre (SRC) 2017–2018 were identified from a clinical database. Data were gathered from the digital record as part of a service review. Results 34 patients had a trial of NCT. 25 patients passed the initial trial which was conducted in the SRC, trial failure was due to treatment intolerance or a drop in FEV1>15%. Of those who passed the trial, 7 could not continue the treatment for >1 month due to either side effects or a decrease in FEV1>15% on review. A successful trial was defined as treatment for >1 month. Conclusion NCT can be difficult to tolerate but in patients who are able to tolerate therapy it is effective in reducing burden of pseudomonas and hospital admissions.