即使吸入型抗生素(inhaled antibiotics)是治療囊腫性纖維化(Cystic fibrosis)的標準治療方式，至今吸入性抗生素在治療非囊腫性纖維化引起之支氣管擴張(Bronchiectasis)上角色仍未明。相較於全身性抗生素的使用，吸入型抗生素較無副作用且直接作用在呼吸道上，局部濃度高且殺菌效果好，是較理想的治療方式。回顧文獻顯示使用吸入型抗生素在支氣管擴張之患者身上可以降低呼吸道細菌總量以及急性惡化風險，但是相對於病人的生活品質則無明顯改善。2017年歐洲呼吸學會所發表支氣管擴張症指引，已經建議使用吸入型抗生素在治療慢性綠膿桿菌感染之支氣管擴張症患者。本文統整吸入型抗生素治療的可能機轉以及較新的大型試驗結果，同時也和macrolides作比較，提供大家在治療非囊腫性纖維化引起之支氣管擴張症的另一種選擇。

Although the use of inhaled antibiotics is the standard of care in cystic fibrosis, there is insufficient evidence to support use of inhaled antibiotics in patients with bronchiectasis not due to cystic fibrosis. Compared with systemic antibiotics, inhaled antibiotics could provide higher drug concentration locally at bronchus with well treatment effect. It is also a safe treatment way for bronchiectasis not due to cystic fibrosis with mild side effect of bronchospasm. Inhaled antibiotics can reduce airway bacterial load and achieved a significant reduction in exacerbation frequency. However, we cannot use inhaled antibiotics to make improvements in quality of life for these patients. According to 2019 British Thoracic Society Guideline for bronchiectasis in adults, we suggest offering long-term antibiotic treatment for adults with bronchiectasis who have three or more exacerbations per year. Especially for the patient with chronic Pseudomonas aeruginosa infection. Besides inhaled antibiotics, macrolides are also very effective treatment for bronchiectasis not due to cystic fibrosis. We can make different treatment choice based on different patient’s condition.