Advances in inhaled antibiotics for management of respiratory tract infections

Abstract

Purpose of reviewThe incidence of bacterial respiratory tract infections is growing. In a context of increasing antibiotic resistance and lack of new classes of antibiotics, inhaled antibiotics emerge as a promising therapeutic strategy. Although they are generally used for cystic fibrosis, their use in other conditions is becoming more frequent, including no-cystic fibrosis bronchiectasis, pneumonia and mycobacterial infections.Recent findingsInhaled antibiotics exert beneficial microbiological effects in bronchiectasis and chronic bronchial infection. In nosocomial and ventilator-associated pneumonia, aerosolized antibiotics improve cure rates and bacterial eradication. In refractory Mycobacterium avium complex infections, amikacin liposome inhalation suspension is more effective in achieving long-lasting sputum conversion. In relation to biological inhaled antibiotics (antimicrobial peptides, interfering RNA and bacteriophages), currently in development, there is no still enough evidence that support their use in clinical practice.SummaryThe effective antimicrobiological activity of inhaled antibiotics, added to their potential to overcoming resistances to systemic antibiotics, make inhaled antibiotics a plausible alternative.

Establishment of an Inhalation Administration Non-invasive Murine Model for Rapidly Testing Drug Activity againstMycobacterium tuberculosis

“…Despite ongoing efforts, the development of effective anti- M. tuberculosis drugs remains confronted with numerous challenges, including the complexity of evaluation process and the emergence of drug-resistant strains (McGrath et al, 2014, Olaru et al, 2015). Over the past several decades, inhalable therapy has emerged as a promising approach for treating pulmonary infections, offering improved cure rates and bacterial eradication (Riveiro et al, 2023). However, the evaluation of inhalable drugs still presents challenges such as complex manipulation and time-consuming results completion.…”

“…Over several decades of continuous research, only bedaquiline, pretomanid and delamanid have received approved for clinical use (Pontali et al, 2013). Recently, inhaled administration has emerged as a promising approach for the treatment of plumonary infections, offering improved cure rates and bacterial eradication (Riveiro et al, 2023). However, the evaluation of inhalable drugs still presents challenges such as complex manipulation and time-consuming processes.…”

Nebulised/aerosolised drugs in anaesthesiology, critical care and pain practice–benefit with a professional hazard!

“…Similarly, the aerosolised route has been used for a long time for administering antibiotics. [ 14 15 ] More and more antibiotics have been added to this armamentarium in recent years because of their beneficial effects. This risks exposing other patients and healthcare workers to aerosolised antibiotic molecules.…”