Pulmonary drug delivery systems for antimicrobial agents: facts and myths

International Journal of Antimicrobial Agents
Matthew E FalagasEugenios I Metaxas

Abstract

Inhaled antimicrobial agents are used for the treatment of respiratory tract infections due to Gram-negative bacteria, mainly Pseudomonas aeruginosa. The effectiveness of the inhaled antimicrobial therapy is believed to correlate with the delivery system used. The objective of this review was to search for data supporting differentiation in clinical effectiveness between systems used for pulmonary delivery of antibiotics, including delivery using disposable nebulisers and oxygen flow. Published studies in peer-reviewed journals comparing the effectiveness of pulmonary drug delivery systems for antimicrobial agents were retrieved. The studies found were either in vitro or Phase I and Phase II clinical studies. Differences in in vitro parameters may affect the in vivo efficacy of the devices, and in vivo differences may imply differences in clinical effectiveness. The main difference between newer and older devices is the time needed for antibiotic delivery. Interpretation and association with clinical effectiveness is difficult. In conclusion, Phase III clinical trials comparing the clinical effectiveness of delivery systems, including delivery using a hospital's oxygen flow and disposable nebulisers, do not exist. Cost is an im...Continue Reading

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Citations

Oct 30, 2010·Paediatric Drugs·Mireille van Westreenen, Harm A W M Tiddens
Jan 9, 2013·Expert Opinion on Drug Metabolism & Toxicology·Xin LiuMichael S Roberts
May 30, 2019·Frontiers in Medicine·Michael S Niederman
Apr 20, 2021·Expert Review of Respiratory Medicine·Sujit Kumar DebnathAbdelwahab Omri
Mar 23, 2019·Molecular Pharmaceutics·Rabeb Mouna DerbaliJeanne Leblond Chain

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