***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: Background : No prospect i ve study has assessed eradication treatment of early Pseudomonas aeruginosa colonisation in bronchiectasis not due to cystic fibrosis ( CF ) . Objectives : To evaluate the efficacy of 3 months of nebulised tobramycin after a short course of intravenous antibiotics in the eradication of P. aeruginosa and its clinical consequences in non- CF bronchiectasis following initial P. aeruginosa infection . Methods : A 15-month , single-masked , r and omised study including 35 patients was conducted in a tertiary university hospital . Following the isolation of P. aeruginosa and a 14-day intravenous treatment with ceftazidime and tobramycin , patients received 300 mg nebulised tobramycin twice daily or placebo during 3 months , and were followed up for 12 months thereafter . Results : The median time to recurrence of P. aeruginosa infection was higher in the tobramycin than in the placebo group ( p = 0.048 , log-rank test ) . At the end of the study 54.5 % of the patients were free of P. aeruginosa in the tobramycin group and 29.4 % in the placebo group . The numbers of exacerbations ( p = 0.044 ) , hospital admissions ( p = 0.037 ) and days of hospitalisation ( p = 0.034 ) were lower in the tobramycin than in the placebo group . A global , non-significant trend to improvement in the tobramycin group was observed in most of the other studied parameters on comparing the two groups . Bronchospasm in the tobramycin group was remarkable . Conclusions : Our study shows that 3 months of nebulised tobramycin following a short course of intravenous antibiotics may prevent bronchial infection with P. aeruginosa and has a favourable clinical impact on non-CF bronchiectasis PURPOSE Viable bacteria are often isolated from airway secretions in clinical ly stable patients with chronic bronchitis . We hypothesized that the number of organisms and bacterial species might be important modulators of airway inflammation . SUBJECTS AND METHODS We performed quantitative sputum cultures in 160 stable patients [ 55 with chronic obstructive pulmonary disease ( COPD ) and normal serum alpha(1)-antitrypsin levels , 62 with COPD and severe alpha(1)-antitrypsin deficiency ( PiZ ) , and 43 with idiopathic bronchiectasis ] . The results were related to several indicators of the mechanisms and severity of airway inflammation . RESULTS Airway bacterial load correlated with sputum myeloperoxidase level , an indirect measure of neutrophil activation and number ( r = 0.50 , P<0 . 001 ) ; sputum neutrophil chemoattractants [ interleukin-8 level ( r = 0 . 68 , P<0.001 ) and leukotriene B4 level ( r = 0.53 , P<0.001 ) ] ; sputum leukocyte elastase activity ( r = 0.55 , P<0.001 ) ; and albumin leakage from serum to sputum ( r = 0.26 , P<0.01 ) . Markers of inflammation increased at bacterial loads of 10(6 ) to 10(7 ) colony-forming units per milliliter , and increased progressively with increasing bacterial load . For example , the median ( interquartile range ) sputum myeloperoxidase level was 0.3 U/mL ( 0.1 to 0.5 U/mL ) for patients who were not colonized or who had mixed normal oropharyngeal flora alone ; 0.5 U/mL ( 0.2 to 0.7 U/mL ) for patients with 10(5 ) to 10(6 ) colony-forming units per milliliter ( P = 0.07 ) ; 0.5 U/mL ( 0.3 to 1.2 U/mL ) for patients with 10(6 ) to 10(7 ) colony-forming units per milliliter ( P<0.01 ) ; 0.7 U/mL ( 0.3 to 1.2 U/mL ) for patients with 10(7 ) to 10(8 ) colony-forming units per milliliter ( P < 0.005 ) ; and 2.4 U/mL ( 0.7 to 4.8 U/mL ) for patients with 10(8 ) or greater colony-forming units per milliliter ( P<0.0001 ) . The bacterial species influenced airway inflammation ; for example , sputum myeloperoxidase activity was greater ( P<0.005 ) in patients colonized with Pseudomonas aeruginosa [ median 32 U/mL ( interquartile range , 20 to 65 U/mL ) ] than those colonized with nontypeable Hemophilus influenzae [ 4 U/mL ( 2 to 31 U/mL ) ] , which in turn was greater ( P = 0.01 ) than among those colonized with Moraxella catarrhalis [ 1.1 U/mL ( 0.6 to 1.8 U/mL ) ] . We did not find a relation between bacterial load and lung function . CONCLUSIONS The bacterial load and species contribute to airway inflammation in patients with stable chronic bronchitis . Further studies are required to determine the consequences of bacterial colonization on patient morbidity and decline in lung function BACKGROUND AND AIMS Inhalation of hypertonic saline ( HTS ) has short term positive effects on airways clearance in non-cystic fibrosis ( CF ) bronchiectasis , however its long term effects are unknown . The aim of this study was to determine the effect of HTS 6 % on exacerbations , quality of life ( QOL ) and respiratory function over 12 months in non-CF bronchiectasis . METHODS Forty patients were r and omised to inhale isotonic saline ( IS ) 0.9 % or HTS 6 % daily for 12 months . Participants recorded their symptoms in a daily diary . Quality of life and respiratory function were measured after three , six and 12 months . Number of exacerbations and changes in sputum colonisation were recorded at 12 months . Participants , assessors and clinicians were blinded to group allocation . RESULTS The exacerbation rate at 12 months was similar in the two groups and similar clinical ly significant improvements in QOL were seen in both groups . The FEV(1 ) increased in both groups after six months ( mean 90 ml , 95 % confidence interval 11 - 169 ml ) with no difference between groups ( p = 0.394 ) . The FEF(25 - 75 % ) significantly improved at all time points ( mean increase at 12 months 187 ml , 69 - 304 ml ) with no difference between groups ( p = 0.705 ) . There was a reduction in sputum colonisation in both groups ( p = 0.046 ) . CONCLUSIONS Inhalation of HTS or IS has similar effects on exacerbations , QOL , sputum colonisation and respiratory function over 12 months in non-CF bronchiectasis . The trial was registered with both Clinical Trials.gov - NCT00484263 and Australian New Zeal and Clinical Trials Registry - ACTRN12607000367448 UNLABELLED Neutrophil elastase ( NE ) activity is increased in bronchiectasis and may play a role in this condition . We wished to determine the effect of AZD9668 , a selective oral inhibitor of NE . Efficacy and safety of AZD9668 60 mg twice daily over 4 weeks were evaluated in a r and omised , double-blind , placebo-controlled , parallel-group , Phase II , signal- search ing study in patients with bronchiectasis . Outcome measures included : waking and post-waking sputum neutrophil counts ; lung function tests ; 24-h sputum weight ; BronkoTest ( ® ) diary card data ; St George 's Respiratory Question naire for COPD patients ( SGRQ-C ) ; sputum NE activity ; inflammatory biomarker levels ; desmosine levels ; adverse events , safety haematology and biochemistry . AZD9668 levels in plasma and sputum were measured to confirm exposure . Thirty-eight patients were r and omised : 16 to placebo and 22 to AZD9668 . There was no change in sputum neutrophils with AZD9668 . Forced expiratory volume in 1 s improved by 100 mL in the AZD9668 group compared with placebo ( p = 0.006 ) . Significant changes ( defined a priori as p < 0.1 ) in favour of AZD9668 were also seen in slow vital capacity , plasma interleukin-8 , and post-waking sputum interleukin-6 and Regulated on Activation , Normal T-cell Expressed and Secreted levels . Non-significant changes in favour of AZD9668 were seen in other lung function tests , sputum weight and the SGRQ-C.  AZD9668 was well tolerated . In this small signal- search ing study , 4 weeks ' treatment with AZD9668  improved lung function  in patients with bronchiectasis and there were trends for reductions in sputum inflammatory biomarkers . Larger studies of longer duration would be needed to confirm the potential benefits of this agent in bronchiectasis . REGISTRATION NCT00769119 BACKGROUND AND OBJECTIVE We evaluated the efficacy of a 12-week oral treatment with azithromycin in adult patients with bronchiectasis . The objectives were to demonstrate that this treatment reduces sputum volume , improves quality of life and to assess the lengths of effects after cessation of therapy . METHODS Seventy-eight patients with bronchiectasis confirmed by high-resolution computed tomography were included in this study . Subjects received oral azithromycin or placebo in a r and omized manner for 12 weeks followed by placebo for another 12 weeks . Sputum volume , St George 's Respiratory Question naire ( SGRQ ) score and spirometry were recorded at baseline , 12 weeks and 24 weeks , respectively . End-point measurements were compared from baseline to the end of each study phase . RESULTS Sixty-eight subjects were included in the analysis . Mean 24-h sputum volume significantly decreased ( P < 0.01 ) during the active treatment phase and remained low during the control phase ( P < 0.01 ) . The mean SGRQ total score with azithromycin decreased ( i.e. improved health status ) from baseline by more than the 4 points at the end of 12 and 24 weeks . Lung functions remained stable during oral azithromycin therapy and the subsequent control phase . CONCLUSIONS Twelve weeks administration of azithromycin in bronchiectasis produces significant reductions in mean sputum volume , health status and stabilization of lung function values . Sputum volume reduction and the improvement of quality of life were sustained for 12 weeks after cessation of azithromycin . ( Clinical trials.gov number NCT02107274 ) BACKGROUND Inhaled dry powder mannitol enhanced mucus clearance and improved quality of life over 2 weeks in non-cystic fibrosis bronchiectasis . This study 's objective was to investigate the efficacy and safety of dry powder mannitol over 12 weeks . METHODS Patients with bronchiectasis confirmed by high-resolution CT ( H RCT ) scan , aged 15 to 80 years , with FEV1≥50 % predicted and ≥1 L participated in a r and omized , placebo-controlled , double-blind study . Patients with a negative mannitol provocation test were r and omized to inhale 320 mg mannitol ( n=231 ) or placebo ( n=112 ) bid for 12 weeks . To further assess safety , the same mannitol dose/frequency was administered to a patient subset in an open-label extension over 52 weeks . Primary end points were changes from baseline at 12 weeks in 24-h sputum weight and St. George 's Respiratory Question naire ( SGRQ ) score . RESULTS There was a significant difference of 4.3 g in terms of change in sputum weight over 12 weeks ( 95 % CI , 1.64 - 7.00 ; P=.002 ) between mannitol and placebo ; however , this was largely driven by a decrease in sputum weight in the placebo group . This was associated , in turn , with more antibiotic use in the placebo group ( 50 of 112 [ 45 % ] ) than in the inhaled mannitol group ( 85 of 231 [ 37 % ] ) . There was no statistical difference between the groups ( P=.304 ) in total SGRQ score  ( mannitol , -3.4 points [ 95 % CI , -4.81 to -1.94 ] vs placebo , -2.1 points [ 95 % CI , -4.12 to -0.09 ] ) . In a subgroup study ( n=82 ) , patients receiving mannitol  showed less small airway mucus plugging on H RCT scan at 12 weeks compared with patients receiving placebo ( P=.048 ) . Compliance rates were high , and mannitol was well tolerated with adverse events similar to those of placebo . CONCLUSION Because the difference 
    Output:
    
Our analysis shows that quality of life and exacerbation end-points are most frequently used .
The majority of studies measure lung function ( e.g. forced expiratory volume in 1 s ) , but this is shown to be nonresponsive to the majority of interventions .
Microbiology end-points frequently show statistically significant differences in phase 2 antibiotic studies but their correlation with clinical end-points is unknown .