A Case of Effective Long-Term Tobramycin Inhalation in a Patient With Bronchiectasis and Refractory Pseudomonas aeruginosa Infection.

Bronchiectasis predisposes patients to refractory airway infections and significantly reduces their quality of life. Here, we report a case of a 78-year-old woman with refractory Pseudomonas aeruginosa infection complicating bronchiectasis. After P. aeruginosa acquired resistance to quinolones, outpatient treatment became difficult, and the patient experienced repeated exacerbations and hospitalisations. Ceftazidime was effective; however, the patient could not be discharged because symptoms worsened immediately after its discontinuation. Initiating nebulised tobramycin for home use markedly improved symptoms and prevented subsequent exacerbation. Furthermore, P. aeruginosa isolated from sputum 1 year after initiating nebulised tobramycin regained susceptibility to quinolones. This case suggests that nebulised tobramycin is a viable and effective option for long-term management of chronic P. aeruginosa infection complicating bronchiectasis.