Inhaled Antibiotic Therapy for the Treatment of Upper Respiratory Tract Infections

Abstract

Upper respiratory tract infections (URTIs), primarily acute rhinopharyngitis, tonsillitis, adenoiditis, and rhinosinusitis (RS), are major causes of morbidity in both children and adults of any age. In addition to the frequent occurrence of related medical problems and the associated socioeconomic costs, URTIs have a significant impact on the quality of life of patients and their families, and have placed an escalating financial burden on the global healthcare system. Most URTIs are caused by viruses and require only symptomatic treatment. However, a number of cases, particularly those that are severe, recurrent, or chronic, have a bacterial etiology and need appropriate antimicrobial treatment to avoid complications or frequent exacerbations. To ensure therapeutic antibiotic concentration without any significant systemic drug exposure, the direct delivery of antibiotics to the upper respiratory tract by inhalation is a potential solution. The main aim of this review is to determine if and when aerosolized antibiotics can be effectively used to treat URTIs in noncystic fibrosis (non-CF) patients. There is a lack of strong evidence for the use of nebulized antibiotics to treat URTIs in non-CF patients. The only disease for which positive results have been reported is chronic RS in adults. However, conflicting conclusions have been drawn, and many problems related to the drug of choice, dosages, duration of treatment, and the best device for administration remain unsolved. Further studies are needed to better determine when and through which treatment modalities inhaled antibiotics can positively modify the course of chronic RS.

Knowledge and current practices of ICU nurses regarding aerosol therapy for patients treated with invasive mechanical ventilation: A nationwide cross‐sectional study

“…Gentamicin, amikacin, tobramycin and colistin/polymyxin B all have good effects on the three diseases mentioned previously. However, some other drugs, such as ceftazidime, have no effect on NCFB, and vancomycin only has an effect on VAP (Esposito et al, 2017;Mogayzel et al, 2013;Restrepo et al, 2015). Of note, 219 (11.1%) respondents reported that antibiotics as an atomised drug were used in their ICU, whereas bronchodilation was the most commonly used aerosol therapy.…”

Bacterial infections of the upper respiratory tract: how to treat?

“…Чаще всего при вирусных инфекциях поражаются верхние дыхательные пути, и наибольшее распространение, помимо повышения температуры, имеют такие симптомы, как насморк, кашель, боль в ухе или в горле [12].…”

Acute Tonsillitis in Children: The Principle “Zap and It’s Done!”?

“…Именно с вирусными тонзиллитами мы стал-киваемся почти в 80% случаев [16]. Лечение такого тон-зиллита подразумевает симптоматические средства -купирование болевого синдрома при его наличии, мест-нодействующие антисептики, а также снижение высокой температуры, если она есть [2]. [17][18][19].…”

“…Рассматриваются также альтернативные 5-дневные курсы лечения для цефуроксима аксетила и азитромицина и даже ведутся работы по возможности назначения антибиотика в виде спреев и ингаляций [2].…”