Inhaled antimicrobial therapy.
Although antimicrobial therapy has been administered through the inhaled route for decades, it has always been controversial. There are relatively few accepted indications for this mode of administration. Well-controlled studies of aerosolized antibiotics in cystic fibrosis demonstrate that tobramycin on a cyclical basis may reduce sputum volume, bacterial counts, and improve pulmonary function. Preliminary data indicate that inhaled antibiotic therapy of ventilator-associated tracheobronchitis may reduce sputum volume, but the clinical significance of this finding remains to be determined. Inhaled pentamidine is used for prophylaxis of Pneumocystis carinii in patients with human immunodeficiency virus infection who are intolerant of oral prophylactic agents. Ribavirin has been used for 30 years to treat respiratory syncytial virus. The role, if any, of inhaled antifungal therapy with amphotericin B remains undetermined.
O'Riordan
T
T
Division of Pulmonary and Critical Care Medicine, State University of New York at Stony Brook, 11794-8172, USA.
Faris
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M
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000280:Administration, Inhalation; D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001991:Bronchitis / Q000188:drug therapy; D015169:Colony Count, Microbial; D003550:Cystic Fibrosis / Q000188:drug therapy; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000821:virology; D010419:Pentamidine / Q000627:therapeutic use; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy; D012121:Respiration, Artificial / Q000009:adverse effects; D012254:Ribavirin / Q000627:therapeutic use; D013183:Sputum / Q000187:drug effects; D014031:Tobramycin / Q000627:therapeutic use; D014136:Tracheitis / Q000188:drug therapy
D000336:Aerosols; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000935:Antifungal Agents; D000998:Antiviral Agents; D012254:Ribavirin; D010419:Pentamidine; D014031:Tobramycin