Aerosolized antibiotics in cystic fibrosis: an update

Expert Rev Respir Med. 2014 Jun;8(3):305-14. doi: 10.1586/17476348.2014.896205.

Abstract

Inhaled antibiotic therapy, targeting Pseudomonas aeruginosa, is a fundamental component of cystic fibrosis (CF) management. Tobramycin inhalation solution (TIS) was approved in the United States (US) in 1998. Subsequent research efforts focused on developing products with a reduced treatment time burden. Aztreonam for inhalation solution (AZLI), administered via a more efficient nebulizer than TIS, was approved in the US in 2010. Dry powder for inhalation (DPI) formulations provide alternatives to nebulized therapy: tobramycin powder for inhalation (also known as TIP™) was approved in the US in 2013, and colistimethate sodium DPI received European approval in 2012. Other aerosolized antibiotics and regimens combining inhaled antibiotics are in development. Inhaled antibiotic rotation (e.g., TIS alternating with AZLI) is an important concept being actively tested in CF.

Keywords: Pseudomonas aeruginosa; aerosolized antibiotic; aztreonam lysine; colistimethate sodium; cystic fibrosis; dry powder for inhalation; inhaled solution; tobramycin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Inhalation
  • Amikacin / administration & dosage
  • Anti-Bacterial Agents / administration & dosage*
  • Aztreonam / administration & dosage
  • Colistin / administration & dosage
  • Colistin / analogs & derivatives
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / microbiology
  • Equipment Design
  • Humans
  • Levofloxacin / administration & dosage
  • Nebulizers and Vaporizers
  • Pseudomonas Infections / drug therapy
  • Pseudomonas aeruginosa / drug effects
  • Randomized Controlled Trials as Topic
  • Tobramycin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Amikacin
  • colistinmethanesulfonic acid
  • Aztreonam
  • Tobramycin
  • Colistin