Seven versus Fourteen Days Antibiotics for Patients with Bronchiectasis Requiring Intravenous Antibiotics (SBIVA)

Research summary

Bronchiectasis affects around 300,000 people in the UK, according to British Lung Foundation research. Hospital admissions due to bronchiectasis cost the NHS around £40 M per year. International guidelines recommend that patients receive intravenous antibiotics for 14 days if they are particularly unwell, have an infection with resistant organisms, or if oral antibiotics are ineffective. The duration is based on expert advice but there have not been any randomised placebo controlled trials telling us what length of course is best. Treating for too long may keep people in hospital too long or increase their risk of antibiotic side effects, treating for too short a period may increase the risk of another infection soon after completion of antibiotics. A study in Edinburgh of 90 patients showed that patients and clinicians would enter a trial of shorter courses of intravenous antibiotic treatment. Patients receiving 7 days of intravenous antibiotics took longer to next flare up compared to those getting current recommendation of 14 days, challenging the current thinking that “more is better”. A multi-centre trial is now needed to confirm this and change the national and international guidelines recommending 14 days of treatment. This study could add to the goal of reducing inappropriate antibiotic use and reduce the chance of developing antibiotic resistance. We will select 400 patients with bronchiectasis throughout the UK who need intravenous antibiotic treatment. Half, at random, will receive 7 days of open labelled intravenous antibiotics and the other half will receive 14 days of open labelled intravenous antibiotics. Both groups will receive standard care in addition and be followed up for one year. The Research question being addressed by this study proposal is: for bronchiectasis-related pulmonary exacerbations, is 7- or 14-days’ duration of intravenous antibiotic treatment better in delaying the next exacerbation? The study is being funded by NIHR.

Principal Investigator

Dr William Flowers

Contact us

Email: samantha.chilcott@ndm.ox.ac.uk

IRAS number

1007537