Long Term Nebulised Gentamicin in Patients With Bronchiectasis

Inclusion Criteria: * Bronchiectasis confirmed by HRCT of the chest * Clinically stable (not requiring antibiotics for at least 4 weeks preceding the study start date) * Aged 18-70 * Chronic sputum production \> 5 mls for the majority of days in 3 months before enrolment * Chronically colonized (on at least 2 occasions in the preceding 12 months) whilst clinically stable * At least two exacerbations in the past year * Patients able to tolerate a nebulized gentamicin challenge * FEV1 \> 30% predicted * Smoking \< 20 pack year history and ex-smokers \>1 year. Exclusion Criteria: * Cystic fibrosis * Emphysema on HRCT chest * Thoracic surgery within the past 1 year * Allergic bronchopulmonary aspergillosis * Poorly controlled asthma ( \> 20% diurnal variation in peak expiratory flows despite treatment) * Unstable angina or uncontrolled congestive cardiac failure * Active malignancy * Pregnancy or breast feeding * Creatinine clearance \< 30 mls/minute * Vestibular instability * Previous documented intolerance to aminoglycosides