Clinical perspective on aztreonam lysine for inhalation in patients with cystic fibrosis

Daddario, Martha K; Hagerman, Jennifer K; Klepser, Michael E.

doi:10.2147/idr.s7838

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…For example, aztreonam lysine is designed for inhalation, whereas the i.v. form of aztreonam contains arginine, which has been associated with pulmonary inflammation after long-term inhalation (89). Table 1 shows a summary of the major advantages and disadvantages of commonly used inhaled delivery devices.…”

Section: Delivery Devicesmentioning

confidence: 99%

Inhaled Antibiotics for Gram-Negative Respiratory Infections

et al. 2016

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SUMMARYGram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects,in vitroand microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena.

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Section: Delivery Devicesmentioning

confidence: 99%

Inhaled Antibiotics for Gram-Negative Respiratory Infections

et al. 2016

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“…1 ) is a synthetic monocyclic beta-lactam antibiotic that inhibits synthesis of the mucopeptide in the bacterial cell wall [51] . The intravenous form of aztreonam contained arginine which can cause pulmonary inflammation after long-term use by inhalation [52] . The inhalation product contains lysine and is well tolerated [53] , [54] .…”

Section: Inhaled Antibioticsmentioning

confidence: 99%

Inhaled anti-infective chemotherapy for respiratory tract infections: Successes, challenges and the road ahead

Velkov

Rahim

Zhou

et al. 2015

Advanced Drug Delivery Reviews

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One of the most common causes of illnesses in humans is from respiratory tract infections caused by bacterial, viral or fungal pathogens. Inhaled anti-infective drugs are crucial for the prophylaxis and treatment of respiratory tract infections. The benefit of anti-infective drug delivery via inhalation is that it affords delivery of sufficient therapeutic dosages directly to the primary site of infection, while minimizing the risks of systemic toxicity or avoiding potential suboptimal pharmacokinetics/pharmacodynamics associated with systemic drug exposure. This review provides an up-to-date treatise of approved and novel developmental inhaled anti-infective agents, with particular attention to effective strategies for their use, pulmonary pharmacokinetic properties and safety.

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Clinical Pharmacokinetics of Inhaled Antimicrobials

2015

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Administration of inhaled antimicrobials affords the ability to achieve targeted drug delivery into the respiratory tract, rapid entry into the systemic circulation, high bioavailability and minimal metabolism. These unique pharmacokinetic characteristics make inhaled antimicrobial delivery attractive for the treatment of many pulmonary diseases. This review examines recent pharmacokinetic trials with inhaled antibacterials, antivirals and antifungals, with an emphasis on the clinical implications of these studies. The majority of these studies revealed evidence of high antimicrobial concentrations in the airway with limited systemic exposure, thereby reducing the risk of toxicity. Sputum pharmacokinetics varied widely, which makes it challenging to interpret the result of sputum pharmacokinetic studies. Many no vel inhaled antimicrobial therapies are currently under investigation that will require detailed pharmacokinetic studies, including combination inhaled antimicrobial therapies, inhaled nanoparticle formulations of several antibacterials, inhaled non-antimicrobial adjuvants, inhaled antiviral recombinant protein therapies and semi-synthetic inhaled antifungal agents. Additionally, the development of new inhaled delivery devices, particularly for mechanically ventilated patients, will result in a pressing need for additional pharmacokinetic studies to identify optimal dosing regimens.

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Clinical perspective on aztreonam lysine for inhalation in patients with cystic fibrosis

Cited by 5 publications

References 33 publications

Inhaled Antibiotics for Gram-Negative Respiratory Infections

Inhaled Antibiotics for Gram-Negative Respiratory Infections

Inhaled anti-infective chemotherapy for respiratory tract infections: Successes, challenges and the road ahead

Clinical Pharmacokinetics of Inhaled Antimicrobials

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