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Inhaled Antibiotics for Gram-Negative Respiratory Infections

Eric Wenzler1, Dustin R Fraidenburg2, Tonya Scardina3

  • 1University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois, USA.

Clinical Microbiology Reviews
|May 27, 2016
PubMed

Insights

Inhaled antibiotics offer a promising strategy to combat rising antibiotic resistance in Gram-negative respiratory infections. This approach enhances drug delivery to the lungs while minimizing systemic toxicity, warranting further clinical study.

Area of Science:

  • Microbiology
  • Pharmacology
  • Pulmonology

Background:

  • Gram-negative bacteria are major causes of nosocomial lower respiratory tract infections.
  • Increasing antibiotic resistance necessitates alternative treatment strategies.
  • Systemic antibiotics have limitations in lung penetration and therapeutic index.

Purpose of the Study:

  • To review formulation, delivery, and clinical outcomes of inhaled antibiotics for non-cystic fibrosis respiratory infections.
  • To highlight complexities and evidence gaps in inhaled antibiotic administration.
  • To advocate for further study and clinical adoption of inhaled antibiotics.

Main Methods:

  • Comprehensive literature review of inhaled antibiotics.
  • Analysis of formulation and drug delivery aspects.
  • Evaluation of pharmacokinetic/pharmacodynamic data and clinical outcomes.

Main Results:

  • Inhaled antibiotics can maximize lung concentrations and optimize therapeutic indices.
  • This route minimizes systemic exposure and associated toxicities.
  • Evidence for inhaled antibiotics in non-cystic fibrosis indications is limited but promising.

Conclusions:

  • Inhaled antibiotics represent a viable strategy to address Gram-negative resistance in respiratory infections.
  • Further research and clinical investigation are crucial for wider adoption.
  • Innovation in drug delivery is needed due to a lack of new anti-Gram-negative agents.

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