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Gentamicin + budesonide is an investigational combination therapy being evaluated by Assiut University for the treatment of acute exacerbations of bronchiectasis in mechanically ventilated patients. The treatment involves the local bronchoscopic instillation of gentamicin, an aminoglycoside antibiotic that inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, and budesonide, a potent glucocorticoid that exerts anti-inflammatory effects by activating glucocorticoid receptors. This localized delivery approach aims to achieve high therapeutic concentrations at the site of infection and inflammation while minimizing systemic side effects. It is currently being evaluated in a Phase 4 clinical trial (NCT06209047) to determine its impact on in-hospital mortality and time to ventilator liberation in adult ICU patients with non-cystic fibrosis bronchiectasis.
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