***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to investigate the long-term effectiveness and safety of inhaled antibiotic treatment in non-cystic fibrosis patients with bronchiectasis and chronic infection by Pseudomonas aeruginosa , after st and ard endovenous and oral therapy for long-term control of the infection had failed . After completing a 2-week endovenous antibiotic treatment to stabilize respiratory status , 17 patients were r and omly allocated to a 12-month treatment either with inhaled ceftazidime and tobramycin ( group A ) or a symptomatic treatment ( group B ) . One patient from group A ab and oned inhaled treatment because of bronchospasm and another from group B died before the end of the study . The remaining 15 patients , seven from group A and eight from group B , completed the study . Both groups had similar previous characteristics . The number of admissions and days of admission ( mean + /- SEM ) of group A [ 0.6 ( 1.5 ) and 13.1 ( 34.8 ) ] were lower than those of group B [ 2.5 ( 2.1 ) and 57.9 ( 41.8 ) ] ( P < 0.05 ) . Forced vital capacity ( FVC ) , forced expiratory volume in 1 sec ( FEV1 ) , PAO2 and PACO2 were similar in the two groups at the end of follow-up , showing a comparable decline in these parameters . There were no significant differences either in the use of oral antibiotics or in the frequency of emergence of antibiotic-resistant bacteria between groups . Microbiological studies suggested that several patients had different Pseudomonas aeruginosa strains . None of the patients presented impaired renal or auditory function at the end of the study . This study suggests that long-term inhaled antibiotic therapy may be safe and lessen disease severity in non-cystic fibrosis patients with bronchiectasis and chronic bronchial infection by Pseudomonas aeruginosa which do not respond satisfactorily to antibiotics administered via other routes Nine patients with lower respiratory tract infections were used to study in detail the effect of ampicillin or erythromycin on the colonization patterns of Haemophilus influenzae and Haemophilus parainfluenzae in sputum and saliva . H. influenzae was isolated from purulent sputum of eight patients before the start of treatment .  Ampicillin was more effective than erythromycin at clearing H. influenzae from sputum and in decreasing purulence . By careful characterization of multiple strains , the changes in biotype distribution and antibiotic susceptibility patterns were shown . Five biotypes of H. influenzae were associated with chest infection , with type II predominating . Mixed biotype infections occurred in five patients . Most saliva contained multiple biotypes of H. parainfluenzae . Neither antibiotic selected resistant haemophili in saliva or sputum . After treatment with ampicillin , the mucoid sputum was colonized with ampicillin-susceptible H. parainfluenzae biotypes previously found in saliva . We postulate that as inflammation decreases at the bronchial mucosa , the ampicillin concentration drops , allowing ampicillin-susceptible oral H. parainfluenzae isolates to seed the residual mucoid sputum BACKGROUND Diffuse panbronchiolitis ( DPB ) , characterised by progressive sinobronchial sepsis , is well characterised in Japanese subjects but not in other ethnic groups . The experience with  DPB in seven Chinese patients is described and the clinical profiles compared with those of Japanese subjects . METHODS Seven Chinese patients ( three women ; mean ( SD ) age 48(18.6 ) years , all never smokers ) who attended a teaching hospital centre and fulfilled the diagnostic criteria for DPB were assessed prospect ively for clinical , radiological , lung function , microbiological , and other “ characteristic ” laboratory parameters . RESULTS Lung function assessment showed a typical obstructive pattern ( n = 5 ) and air trapping ( n = 7 ) . Typical bronchiolar infiltration by lymphocytes and plasma cells and accumulation of foamy macrophages in the intraluminal tissue were detected in open lung biopsy specimens ( n = 2 ) . Chest radiographs and high resolution computed tomographic scans revealed hyperinflation , diffuse nodules , bronchial thickening and dilatation , peripheral hypoattenuation , and bronchiolectasis . Radiological improvement , manifest as a reduction in nodular density and bronchial thickening , and persistence of other abnormalities such as air trapping were not accurately depicted by the classical Nakata or Akira classifications . The other “ characteristic ” features such as HLA-B54 , IgG subclass deficiency , raised CD4/CD8 T lymphocyte ratio , cold haemagglutinaemia , raised IgA , IgG , and rheumatoid factor were not present . Treatment with erythromycin led to excellent responses in symptoms , lung function indices , and the radiological picture . A review of the non-Japanese cases in the literature reveals that this absence of typical “ additional features ” in DPB might also be applicable to non-Japanese patients . CONCLUSIONS We report the only series of non-Japanese Mongoloid patients with well characterised DPB who had uncharacteristic investigation profiles . This experience should help other clinicians in the investigation and management of DPB in non-Japanese patients We conducted a placebo-controlled , double-blind , r and omized study to evaluate the microbiological efficacy and safety of inhaled tobramycin for treatment of patients with bronchiectasis and Pseudomonas aeruginosa . Patients were r and omly assigned to receive either tobramycin solution for inhalation ( TSI ) ( n = 37 ) or placebo ( n = 37 ) , which was self-administered twice daily for 4 wk and followed by 2-wk off-drug . At Week 4 , the TSI group had a mean decrease in P. aeruginosa density of 4.54 log(10 ) colony-forming units (cfu)/g sputum compared with no change in the placebo group ( p < 0.01 ) . At Week 6 , P. aeruginosa was eradicated in 35 % of TSI patients but was detected in all placebo patients . Investigators indicated that 62 % of TSI patients showed an improved medical condition compared with 38 % of placebo patients ( odds ratio = 2.7 , 95 % confidence interval [ CI ] 1.1 to 6.9 ) . Tobramycin-resistant P. aeruginosa strains developed in 11 % of TSI patients and 3 % of placebo patients ( p = 0.36 ) . The mean percent change in FEV(1 ) percent predicted from Week 0 to Week 4 was similar for the TSI and placebo groups ( p = 0.41 ) . More TSI-treated patients than placebo patients reported increased cough , dyspnea , wheezing , and noncardiac chest pain , but the symptoms did not limit therapy . Additional study is warranted to further evaluate TSI in bronchiectasis patients Increased airway responsiveness ( AR ) is frequently associated with bronchiectasis .  Roxithromycin is a new semisynthetic macrolide antibiotic that also has anti-inflammatory activities . This study was design ed to see whether roxithromycin could favourably alter the degree of AR in patients with bronchiectasis and increased AR . Twenty five children with bronchiectasis , who had an increased AR ( defined as a provocative concentration of methacholine causing a 20 % fall in forced expiratory volume in one second ( FEV1 ) ( PC20 ) < 25 mg x mL(-1 ) evaluated by the dosimeter method ) , were r and omized , double-blind into two parallel groups . Thirteen of the children were treated with roxithromycin ( 4 mg x kg(-1 ) b.i.d . ) for 12 weeks and 12 received placebo .  FEV1 , sputum purulence and leucocyte scores were assessed every 3 weeks . To estimate AR , high-dose methacholine challenge tests were performed before and after treatment . On the dose-response curve to methacholine , PD20 and maximal response ( two indices of AR ) were measured . Changes in FEV1 were not observed during the course of the study in both groups . A significant improvement in sputum features was noted after 6 weeks of treatment in the roxithromycin group . After 12 weeks of roxithromycin therapy , the geometric mean ( range of 1 SD ) of provocative cumulative dose producing a 20 % fall in FEV1 ( PD20 ) increased significantly ( p<0.01 ) to 169.2 ( 83.2 - 344.2 ) breath units ( BU ) ( 1 BU denotes one inhalation of 1 mg x mL(-1 ) methacholine ) and the mean+/-SD of maximal response decreased significantly ( p<0.01 ) to 32.5+/-6.8 % , as compared with the initial values ( PD20 87.1 ( 47.3 - 160.4 ) BU ; maximal response 40.9+/-7.4 % ) . No significant changes in either parameter were observed in the placebo group . Our results indicate that roxithromycin may decrease the degree of airway responsiveness in patients with bronchiectasis and increased airway responsiveness . Further study is necessary to determine the mechanism by which roxithromycin reduces airway responsiveness in bronchiectasis and its clinical impact Patients with bronchiectasis suffer from sputum production , recurrent exacerbations , and progressive airway destruction .  Erythromycin is effective in diffuse panbronchiolitis , another suppurative airway disorder , although its efficacy is unknown in idiopathic bronchiectasis . A double-blind placebo-controlled study was therefore conducted to evaluate the effects of 8-week administration of low dose erythromycin ( 500 mg b.i.d . ) in steady-state idiopathic bronchiectasis . Patients in the erythromycin group ( n=11 , 8 female , mean age 50+/-15 yrs ) , but not the  placebo group ( n=10 , 8 female , mean age 59+/-16 yrs ) had significantly improved forced expiratory volume in one second , forced vital capacity and 24-h sputum volume after 8 weeks ( p<0.05 ) . There was no parallel improvement in sputum pathogens , leukocytes , interleukin (IL)-1alpha and IL-8 , tumour necrosis factor-alpha , or leukotriene B4 . The results of this pilot study show that low-dose erythromycin improves lung function and sputum volume in bronchiectasis . Further studies are indicated to evaluate the efficacy of long-term erythromycin therapy in bronchiectasis To investigate whether aerosolized gentamicin ( GM ) prevents myeloperoxidase (MPO)-mediated airway injury and mucus hypersecretion , a short course of aerosol therapy ( 3 d ) with GM 40 mg or 0.45 % saline ( saline ) twice per day was conducted . Twenty-eight patients with bronchiectasis and mucus hypersecretion after adequate chest care and hydration were enrolled in a r and omized , double-blind fashion . MPO levels in sputum collected on arising were determined by fluorometric assay at 655 nm before and after treatment . The sputum MPO level significantly decreased in patients receiving aerosolized GM , from 0.22 + /- 0.04 to 0.14 + /- 0.04 U/g ( n = 15 ) , but not in patients with saline inhalation ( 0.23 + /- 0.03 to 0.17 + /- 0.02 U/g ; n = 11 ) . The daily sputum amount significantly decreased from 94.6 + /- 21.6 to 58.1 + /- 17.8 ml ( n = 13 , p < 0.01 ) in the GM group , whereas it increased from 78.6 + /- 25.4 ml to 120.5 + /- 33.9 ml ( n = 11 , p < 0.05 ) in the saline group . The change in the amount of daily sputum was related to that in the sputum MPO level in the GM group ( r = 0.61 ; p < 0.01 ) . Inhalation of GM , but not saline , significantly ( p < 0.05 ) increased the value of peak expiratory flow ( PEF ) from 186.4 + /- 25.1 to 216.4 + /- 26.4 L/min and decreased the variability of PEF from 24.6 + /- 5.1 to 6.1 + /- 2.3 % . The nocturnal desaturation and the 6-min walking distances were also significantly improved in the GM group ( 11.2 + /- 3.8 to 0.6 + /- 0.5 min/h ; 324.9 + /- 43.1 to 408.1 + /- 25.9 m ; p < 0.05 ; respectively ) , but not in the saline group . Subjective improvements in the Borg scale and self-sputum assessment were found in the GM group only . In conclusion , aerosolized GM is effective in improving airway hypersecretion and inflammation in patients with bronchiectasis Summary 32 hospitalized adult patients with infective episodes of bronchiectasis were enrolled in an ongoing double-blind , placebo-controlled study comparing ofloxacin with amoxicillin . They were r and omized to receive either 
    Output:
    
The evidence available shows a small benefit for the use of prolonged antibiotics in the treatment of bronchiectasis .