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Patient attitudes to nebulised antibiotics in the treatment of bronchiectasis: a mixed-methods study

Lookup NU author(s): Dr John Davison, Dr Anna Robinson-BarellaORCiD, Professor Andy HusbandORCiD, Dr Daniel OkeowoORCiD, Dr Katy Hester, Professor Anthony De SoyzaORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background Regular daily nebulised antibiotics are widely used in managing bronchiectasis. This patient population typically has severe bronchiectasis requiring multiple other medications. Given that little is known on patients’ views and preferences for such therapies, this was the focus of our study.Methods To explore patient lived-experience using nebulised antibiotics, focus groups and semi-structured interviews were conducted with patients and carers; these were audio-recorded and transcribed to enable thematic analysis. QSR NVivo facilitated data management. The themes developed from the qualitative data analysis were then used to co-design a questionnaire to capture attitudes and preferences towards nebulised therapy. Questionnaires were completed by patients and statistical analysis was performed. Ethical approval was obtained (13/WS/0036).Results Thirteen patients and carers took part in the study's focus groups, and 101 patients completed the questionnaire. Patients described nebulised therapy as an imposition on their daily routine, in turn affecting reported rates of adherence. Results demonstrated that 10% of all patients using nebulised antibiotics found these hard/very hard to administer. Further, 53% of participants strongly agreed/agreed that they would prefer an antibiotic delivered by an inhaler, over a nebuliser, if it was as effective at preventing exacerbations. Notably, only 10% of participants wished to remain on nebulised therapy.Conclusions Inhaled antibiotics, delivered via dry power devices were deemed quicker and easier to use by patients. Providing they were at least as effective as current nebulised treatments, patients deemed inhaled antibiotics to be a preferable treatment option.

Publication metadata

Author(s): Davison J, Robinson-Barella A, Davies G, Campos-Hinojosa M, Collins C, Husband A, Okeowo D, Hester KLM, Lee R, Rapley T, De Soyza A

Publication type: Article

Publication status: Published

Journal: ERJ Open Research

Year: 2023

Volume: 9

Issue: 3

Online publication date: 10/05/2023

Acceptance date: 17/03/2023

Date deposited: 15/05/2023

ISSN (electronic): 2312-0541

Publisher: European Respiratory Society


DOI: 10.1183/23120541.00735-2022

ePrints DOI: 10.57711/twfp-qz30


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