Aerosol administration of antibiotics

Aerosol administration of antibiotics is an attractive approach to the treatment of the recurrent respiratory infections experienced by patients suffering from cystic fibrosis (CF). Through aerosol administration, drugs can, theoretically, be delivered directly to the target site of infection, i.e. the lumen of the lower respiratory tract, thus enabling smaller doses to be given. This, in turn, should result in reduced costs and decreased potential for systemic toxicity. The efficacy of aerosol antibiotic therapy is, however, influenced by numerous variables, including the type of nebulizer device used to deliver the aerosol, the drug's physical properties, its concentration in the aerosol and particle size, carrier gas and patient factors. The efficacy of aerosol antibiotics in the treatment of CF is controversial. This appears to be due mainly of problems and inconsistencies with clinical trials. However, various antibiotics, including beta-lactams, polymyxins and aminoglycosides, have demonstrated clinical benefits when administered by inhalation to CF patients.