Novel inhaled combined antibiotic formulations in the treatment of Pseudomonas aeruginosa airways infections in cystic fibrosis.
In cystic fibrosis, chronic airways infection caused by Pseudomonas aeruginosa can be treated with inhaled antibiotics such as inhaled tobramycin, aztreonam or colistin. However, biofilm formation induced by this bacterium can reduce the effectiveness of such therapies and can contribute to antibiotic resistance. Inhaled antibiotic combination might represent an optimal antibiofilm strategy in this setting. This review discusses the rationale for combining the antibiotics as well as some emerging or existing combinations. Most of the combinations except for fosfomycin/tobramycin are at an early stage of development. The latter combination was found to be effective in Phase II clinical studies and is planned to be tested in Phase III trials. The clinical data on long-term efficacy are currently missing, but the existing evidence as well as the unmet therapeutic need can prompt the further evaluation of such compounds.
Department of Interdisciplinary - Palliative Care Nursing, University of Medicine and Pharmacy, Grigore T Popa Iasi, Romania, 16 Universităţii Str, Iasi, 700115.
Sabina
S
Antoniu
D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic / Q000379:methods; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000453:epidemiology; D004338:Drug Combinations; D005578:Fosfomycin / Q000008:administration & dosage; D006801:Humans; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000453:epidemiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology; D014031:Tobramycin / Q000008:administration & dosage; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D005578:Fosfomycin; D014031:Tobramycin
Pseudomonas aeruginosa; cystic fibrosis; fosfomycin/tobramycin; inhaled antibiotics; tobramycin