Aerosolized antibiotics: do they add to the treatment of pneumonia?
Marin H Kollef1, Cindy W Hamilton, A Bruce Montgomery
1aVirginia E. and Sam J. Golman Chair in Respiratory Intensive Care Medicine, Washington University School of Medicine, St. Louis, Missouri bVirginia Commonwealth University School of Pharmacy, Richmond cPrincipal, Hamilton House, Virginia Beach, Virginia dCardeas Pharma Corp., Seattle, Washington, USA.
Purpose Of Review:
The increasing rate of ventilator-associated pneumonia (VAP) caused by multidrug-resistant pathogens warrants the development of new treatment strategies. Carefully engineered delivery systems are undergoing evaluation to test the hypothesis that aerosolized administration of antibiotics will provide high local concentrations and fast clearance, which in turn may improve efficacy and decrease the risk of microbial resistance.
Recent Findings:
Recent studies indicate that aerosolized delivery systems for specially formulated antibiotics yield high local concentrations with rapid clearance and low systemic exposure. Preliminary clinical studies reveal that aerosolized delivery of antibiotics is well tolerated and active, when combined with intravenous antibiotics. No single aerosolized antibiotic is likely to provide broad-spectrum activity against both Gram-negative and Gram-positive bacteria.
Summary:
Large multicenter trials are needed to determine whether preliminary findings will translate to improved clinical activity and decreased microbial resistance in VAP patients, and to optimize the use of aerosolized antibiotics.
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