Inhaled antimicrobial therapy - barriers to effective treatment

Adv Drug Deliv Rev. 2015 May;85:24-43. doi: 10.1016/j.addr.2014.08.013. Epub 2014 Sep 1.

Abstract

Inhaled antibiotics dramatically improve targeting of drug to the site of respiratory infections, while simultaneously minimizing systemic exposure and associated toxicity. The high local concentrations of antibiotic may enable more effective treatment of multi-drug resistant pathogens. This review explores barriers to effective treatment with inhaled antibiotics. In addition, potential opportunities for improvements in treatment are reviewed.

Keywords: Biofilm; Dry powder inhaler; Endpoint; Fixed dose combination; Nebulizer; Partial liquid ventilation; Tolerability.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Bronchiectasis / drug therapy
  • Bronchiectasis / microbiology
  • Cystic Fibrosis / drug therapy
  • Cystic Fibrosis / microbiology
  • Drug Delivery Systems / economics
  • Drug Delivery Systems / instrumentation
  • Drug Delivery Systems / methods*
  • Drug Resistance, Multiple, Bacterial* / drug effects
  • Humans
  • Nebulizers and Vaporizers
  • Pneumonia, Ventilator-Associated / drug therapy
  • Pneumonia, Ventilator-Associated / microbiology
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / microbiology
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / microbiology

Substances

  • Anti-Bacterial Agents