Efficacy and Safety of Dry Powder Antibiotics

The use of inhaled antibiotics was initially almost exclusively confined to patients with cystic fibrosis (CF). However, it has been extended in recent decades to patients with non-CF bronchiectasis or chronic obstructive pulmonary disease who present with chronic bronchial infection by potentially...

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Detalles Bibliográficos
Autores: de la Rosa Carrillo, David|||0000-0003-0753-1771, Suarez-Cuartin, Guillermo|||0000-0003-2320-6047, Sibila, Oriol|||0000-0002-4833-6713, Golpe, Rafael|||0000-0002-3759-5322, Girón, Rosa|||0000-0001-7094-0848, Martínez García, Miguel Ángel|||0000-0002-7321-1891
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:301716
Acceso en línea:https://ddd.uab.cat/record/301716
https://dx.doi.org/urn:doi:10.3390/jcm12103577
Access Level:acceso abierto
Palabra clave:Antibiotics
Bronchiectasis
Chronic bronchial infection
Cystic fibrosis
Dry powder antibiotics
Inhalation drug
Pseudomonas aeruginosa
Descripción
Sumario:The use of inhaled antibiotics was initially almost exclusively confined to patients with cystic fibrosis (CF). However, it has been extended in recent decades to patients with non-CF bronchiectasis or chronic obstructive pulmonary disease who present with chronic bronchial infection by potentially pathogenic microorganisms. Inhaled antibiotics reach high concentrations in the area of infection, which enhances their effect and enables their long-term administration to defeat the most resistant infections, while minimizing possible adverse effects. New formulations of inhaled dry powder antibiotics have been developed, providing, among other advantages, faster preparation and administration of the drug, as well as avoiding the requirement to clean nebulization equipment. In this review, we analyze the advantages and disadvantages of the different types of devices that allow the inhalation of antibiotics, especially dry powder inhalers. We describe their general characteristics, the different inhalers on the market and the proper way to use them. We analyze the factors that influence the way in which the dry powder drug reaches the lower airways, as well as aspects of microbiological effectiveness and risks of resistance development. We review the scientific evidence on the use of colistin and tobramycin with this type of device, both in patients with CF and with non-CF bronchiectasis. Finally, we discuss the literature on the development of new dry powder antibiotics.