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New Inhaled Antimicrobial Formulations for Use in the Cystic Fibrosis Patient Population
Christopher T Campbell1, Rachael McCaleb2, Kalen B Manasco3
1Georgia Regents Medical Center, Augusta, GA USA University of Georgia College of Pharmacy, Augusta, GA, USA.
The Annals of Pharmacotherapy
|December 23, 2015
Summary
New inhaled antibiotics show promise for cystic fibrosis (CF) patients, offering potentially similar efficacy and improved ease of use compared to existing treatments. These novel therapies expand options for managing resistant infections in CF care.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Pharmacology
Background:
- Cystic Fibrosis (CF) patients often suffer from chronic respiratory infections, necessitating effective antibiotic treatments.
- Current inhaled antibiotics like tobramycin and aztreonam improve respiratory function but newer agents are being investigated.
- The emergence of resistant organisms in CF necessitates the development of novel therapeutic strategies.
Purpose of the Study:
- To review the current literature on inhaled antibiotic therapies in clinical trials for cystic fibrosis patients.
- To evaluate the efficacy and safety of emerging inhaled antibiotics.
- To compare novel inhaled antibiotics with existing treatments for CF.
Main Methods:
- Comprehensive literature search of PubMed, International Pharmaceutical Abstracts, and MEDLINE (up to September 2015).
- Inclusion of English-language phase II-III studies, case reports, and retrospective studies.
- Search terms included "cystic fibrosis," "inhaled amikacin," "inhaled liposomal amikacin," "inhaled vancomycin," and "inhaled levofloxacin."
Main Results:
- Newer inhaled antibiotics demonstrate potentially similar efficacy to tobramycin and aztreonam, with improved ease of use.
- Inhaled liposomal amikacin and levofloxacin show noninferiority to tobramycin in improving respiratory function.
- Inhaled levofloxacin reduced hospitalizations and Pseudomonas aeruginosa sputum density compared to tobramycin; inhaled vancomycin data are limited.
Conclusions:
- The pipeline for inhaled antibiotics in CF is expanding, offering new choices for patients.
- Novel inhaled therapies target resistant Gram-negative and Gram-positive organisms, enhancing treatment options.
- These advancements provide increased flexibility for eradication and chronic colonization management in CF.
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