{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:38:07Z","timestamp":1791920287484,"version":"4.3.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2012,10,1]],"date-time":"2012-10-01T00:00:00Z","timestamp":1349049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The vicious cycle hypothesis of bronchiectasis argues that bacterial colonization leads to airway inflammation and progressive lung damage. The logical extension of this hypothesis is that acute or chronic antibiotic therapy should improve airway inflammation and clinical outcome. There are little data to support this hypothesis in patients with non\u2013cystic fibrosis (CF) bronchiectasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether acute or chronic antibiotic therapy improves airway inflammation and clinical outcome in non-CF bronchiectasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The relationship between bacterial load and airway and systemic inflammation was investigated in 385 stable patients, 15 stable patients treated with intravenous antibiotics, and 34 patients with an exacerbation of bronchiectasis treated with intravenous antibiotics. Long-term antibiotic therapy was investigated using samples from a 12-month controlled trial of nebulized gentamicin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>In stable patients, there was a direct relationship between airway bacterial load and markers of airway inflammation (P &amp;lt; 0.0001 for all analyses). High bacterial loads were associated with higher serum intercellular adhesion molecule-1, E-selectin, and vascular cell adhesion molecule-1 (P &amp;lt; 0.05 above bacterial load \u22651 \u00d7 107 cfu\/ml). In stable patients, there was a direct relationship between bacterial load and the risk of subsequent exacerbations (odds ratio, 1.20; 95% confidence interval, 1.11\u20131.29; P &amp;lt; 0.0001) and severe exacerbations (odds ratio, 1.11; 95% confidence interval, 1.01\u20131.21; P = 0.02). Short- and long-term antibiotic treatments were associated with reductions in bacterial load, airways, and systemic inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High airway bacterial loads in non-CF bronchiectasis are associated with airway and systemic inflammation and a greater risk of exacerbations. Short- and long-term antibiotic therapy reduce markers of airways and systemic inflammation.<\/jats:p>\n                    <jats:p>Clinical trial registered with www.clinicaltrials.gov (NCT 00749866).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201203-0487oc","type":"journal-article","created":{"date-parts":[[2012,6,29]],"date-time":"2012-06-29T02:01:01Z","timestamp":1340935261000},"page":"657-665","source":"Crossref","is-referenced-by-count":355,"title":["Short- and Long-Term Antibiotic Treatment Reduces Airway and Systemic Inflammation in Non\u2013Cystic Fibrosis Bronchiectasis"],"prefix":"10.1093","volume":"186","author":[{"given":"James D.","family":"Chalmers","sequence":"first","affiliation":[{"name":"The University of Edinburgh\/Medical Research Council Centre for Inflammation Research, The Queen\u2019s Medical Research Institute, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeve P.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"McHugh","sequence":"additional","affiliation":[{"name":"The University of Edinburgh\/Medical Research Council Centre for Inflammation Research, The Queen\u2019s Medical Research Institute, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Doherty","sequence":"additional","affiliation":[{"name":"School of Medicine and Veterinary Medicine, Cystic Fibrosis Group, Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Govan","sequence":"additional","affiliation":[{"name":"School of Medicine and Veterinary Medicine, Cystic Fibrosis Group, Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam T.","family":"Hill","sequence":"additional","affiliation":[{"name":"The University of Edinburgh\/Medical Research Council Centre for Inflammation Research, The Queen\u2019s Medical Research Institute, Edinburgh, United Kingdom"},{"name":"Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2012,10,1]]},"reference":[{"key":"2026032101045869700_bib1","first-page":"6","article-title":"Inflammation: a two-edged sword\u2013the model of bronchiectasis","volume":"147","author":"Cole","year":"1986","journal-title":"Eur J Respir Dis Suppl"},{"key":"2026032101045869700_bib2","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1183\/09031936.00069007","article-title":"Mucosal inflammation in idiopathic bronchiectasis: cellular and molecular mechanisms","volume":"31","author":"Fuschillo","year":"2008","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib3","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1136\/thx.2003.008037","article-title":"Neutrophil apoptosis, proinflammatory mediators and cell counts in bronchiectasis","volume":"59","author":"Watt","year":"2004","journal-title":"Thorax"},{"issue":"Suppl 1","key":"2026032101045869700_bib4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/thx.2010.136119","article-title":"British Thoracic Society guideline for non-CF bronchiectasis","volume":"65","author":"Pasteur","year":"2010","journal-title":"Thorax"},{"key":"2026032101045869700_bib5","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1164\/ajrccm.164.8.2104075","article-title":"Airway inflammation in children with cystic fibrosis and healthy children assessed by sputum induction","volume":"164","author":"Sagel","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib6","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1164\/rccm.200306-731OC","article-title":"Inflammatory and microbiologic markers in induced sputum after intravenous antibiotics in cystic fibrosis","volume":"168","author":"Ordonez","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib7","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1002\/ppul.20646","article-title":"The effect of treatment of cystic fibrosis pulmonary exacerbations on airways and systemic inflammation","volume":"42","author":"Downey","year":"2007","journal-title":"Pediatr Pulmonol"},{"key":"2026032101045869700_bib8","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1378\/chest.113.5.1329","article-title":"Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase. rhDNase study group","volume":"133","author":"O\u2019Donnell","year":"1998","journal-title":"Chest"},{"key":"2026032101045869700_bib9","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1164\/ajrccm.164.9.2105083","article-title":"Bronchial inflammation and colonization in patients with clinically stable bronchiectasis","volume":"164","author":"Angrill","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib10","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S0002-9343(00)00507-6","article-title":"Association between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis","volume":"109","author":"Hill","year":"2000","journal-title":"Am J Med"},{"key":"2026032101045869700_bib11","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1183\/09031936.98.12040820","article-title":"Systemic markers of inflammation in stable bronchiectasis","volume":"12","author":"Wilson","year":"1998","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib12","first-page":"CD001392","article-title":"Prolonged antibiotics for purulent bronchiectasis in children and adults","volume":"18","author":"Evans","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"2026032101045869700_bib13","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1183\/09031936.99.13236199","article-title":"A pilot study of low-dose erythromycin in bronchiectasis","volume":"13","author":"Tsang","year":"1999","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib14","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1164\/rccm.201005-0756OC","article-title":"A randomized controlled trial of nebulized gentamicin in non-cystic fibrosis bronchiectasis","volume":"183","author":"Murray","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib15","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1164\/ajrccm.155.6.9196111","article-title":"Inhaled gentamicin reduces airway neutrophil activity and mucus secretion in bronchiectasis","volume":"155","author":"Lin","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib16","first-page":"163","article-title":"The response of patients with purulent bronchiectasis to antibiotics for four months","volume":"66","author":"Hill","year":"1988","journal-title":"Q J Med"},{"key":"2026032101045869700_bib17","author":"Chalmers"},{"key":"2026032101045869700_bib18","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1034\/j.1399-3003.2000.15d24.x","article-title":"Validation of assays for inflammatory mediators in sputum","volume":"15","author":"Stockley","year":"2000","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib19","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1034\/j.1399-3003.2000.16d21.x","article-title":"Up-regulation of circulating adhesion molecules in bronchiectasis","volume":"16","author":"Zheng","year":"2000","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib20","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1164\/ajrccm.157.4.9704134","article-title":"Circulating adhesion molecules in cystic fibrosis","volume":"157","author":"De Rose","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib21","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1183\/09031936.94.07091673","article-title":"Circulating cell adhesion molecules in bronchial lavage and serum in COPD patients with chronic bronchitis","volume":"7","author":"Riise","year":"1994","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib22","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1183\/09031936.05.00034805","article-title":"Standardisation of spirometry","volume":"26","author":"Miller","year":"2005","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib23","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1164\/ajrccm.156.2.9607083","article-title":"Validation of the St. Georges Respiratory Questionnaire in bronchiectasis","volume":"156","author":"Wilson","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib24","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1183\/09031936.00160508","article-title":"Validation of the Leicester Cough Questionnaire in non-cystic fibrosis bronchiectasis","volume":"34","author":"Murray","year":"2009","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib25","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1164\/ajrccm.162.4.9906120","article-title":"An investigation into causative factors in patients with bronchiectasis","volume":"162","author":"Pasteur","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib26","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1183\/09031936.00003709","article-title":"Mortality in bronchiectasis: a long-term study assessing the factors influencing survival","volume":"34","author":"Loebinger","year":"2009","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib27","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1183\/09031936.97.10081754","article-title":"Effect of sputum bacteriology on the quality of life of patients with bronchiectasis","volume":"10","author":"Wilson","year":"1997","journal-title":"Eur Respir J"},{"key":"2026032101045869700_bib28","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1378\/chest.07-0490","article-title":"Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis","volume":"132","author":"Martinez-Garcia","year":"2007","journal-title":"Chest"},{"key":"2026032101045869700_bib29","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1164\/rccm.200705-664OC","article-title":"Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health","volume":"176","author":"Flume","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032101045869700_bib30","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1042\/cs0740645","article-title":"Neutrophil chemotaxis in bronchiectasis: a study of peripheral cells and lung secretions","volume":"74","author":"Stockley","year":"1988","journal-title":"Clin Sci (Lond)"},{"key":"2026032101045869700_bib31","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1136\/thx.2007.082388","article-title":"Neutrophils in cystic fibrosis","volume":"64","author":"Downey","year":"2009","journal-title":"Thorax"},{"key":"2026032101045869700_bib32","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0140-6736(97)09032-6","article-title":"Plasma concentration of soluble intercellular adhesion molecule-1 and risks of future myocardial infarction in apparently healthy men","volume":"351","author":"Ridker","year":"1998","journal-title":"Lancet"},{"key":"2026032101045869700_bib33","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1161\/01.STR.30.8.1647","article-title":"Adhesion molecules in cerebrovascular diseases. Evidence for an inflammatory endothelial activation in cerebral large-and small-vessel disease","volume":"30","author":"Fassbender","year":"1999","journal-title":"Stroke"},{"key":"2026032101045869700_bib34","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.2337\/db07-0250","article-title":"Circulating levels of endothelial adhesion molecules and risk of diabetes in an ethnically diverse cohort of women","volume":"56","author":"Song","year":"2007","journal-title":"Diabetes"},{"key":"2026032101045869700_bib35","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1378\/chest.07-0058","article-title":"Systemic inflammation and COPD: the Framingham Heart Study","volume":"133","author":"Walter","year":"2008","journal-title":"Chest"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/186\/7\/657\/67248531\/ajrccm_186_7_657.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/186\/7\/657\/67248531\/ajrccm_186_7_657.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T05:05:06Z","timestamp":1774069506000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/186\/7\/657\/8507903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,1]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2012,10,1]]},"published-print":{"date-parts":[[2012,10,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.201203-0487oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2012,10]]},"published":{"date-parts":[[2012,10,1]]}}}