title: Clinical applications of pulmonary delivery of antibiotics.
abstract: The treatment of infection typically involves administration of antibiotics by a systemic route, such as intravenous or oral. However, pulmonary infections can also be approached by inhalation of antibiotics as the infection is more directly accessible via the airways, making inhalation delivery essentially topical administration. This approach offers deposition of high antimicrobial concentrations directly at the site of infection but with a potentially reduced systemic exposure. This review covers the evidence for aerosolized antibiotics for the treatment of a number of conditions such as cystic fibrosis (CF), where it has become the standard of care for chronic infection, as well as non-CF bronchiectasis, non-tuberculous mycobacteria, and ventilator-associated infection where such therapy does not have an approved indication but has been used with increasing frequency.
authors.affiliation: Departments of Medicine and Pediatrics, Medical University of South Carolina, Charleston, SC, United States. Electronic address: flumepa@musc.edu.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Flume
authors.affiliation: Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland OH, United States.
authors.forename: Donald R
authors.initials: DR
authors.lastname: VanDevanter
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000382:microbiology; D045363:Pneumocystis carinii / Q000187:drug effects; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects
chemical_list: D000336:Aerosols; D000900:Anti-Bacterial Agents
keywords: Aerosol; Bronchiectasis; Cystic fibrosis; Inhaled antibiotics; Mycobacteria; Pneumocystis