title: Inhaled drug treatment for tuberculosis: Past progress and future prospects.
abstract: Since the 1990s the rising incidence of multiple drug resistant TB, particularly in the context of human immunodeficiency virus co-infected patients, has threatened global TB control. At that time funding agencies began to support formal investigation of aerosol therapy which until then had been the subject of case reports of individual investigators. Over the last decade, proponents of aerosol therapy have increased in number within the TB research community as the incidence of multiple and extremely drug resistant TB has increased dramatically around the world. Aerosol therapy offers the potential to deliver drug at target concentrations directly into the lungs, use the alveolar-capillary interface to achieve systemic levels, while reducing the risk of systemic toxicity seen with parentally administered doses. In addition, there are insufficient new drugs in the pipeline to anticipate the appearance of a new regimen in time to assure future control of drug resistance. Consequently, alternative strategies are critical to achieving global TB control, and inhaled therapies should be considered as one such strategy.
authors.affiliation: RTI International, Research Triangle Park, 3040 Cornwallis Road, NC 27709, United States. Electronic address: ahickey@rti.org.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hickey
authors.affiliation: RTI International, Research Triangle Park, 3040 Cornwallis Road, NC 27709, United States.
authors.forename: P G
authors.initials: PG
authors.lastname: Durham
authors.affiliation: Brigham and Women's Hospital, Harvard University, 75 Francis Street, Boston, MA 02115, United States.
authors.forename: A
authors.initials: A
authors.lastname: Dharmadhikari
authors.affiliation: Brigham and Women's Hospital, Harvard University, 75 Francis Street, Boston, MA 02115, United States.
authors.forename: E A
authors.initials: EA
authors.lastname: Nardell
mesh_terms: D000280:Administration, Inhalation; D000818:Animals; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000378:metabolism; D005544:Forecasting; D015658:HIV Infections / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D009330:Nebulizers and Vaporizers / Q000639:trends; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D000995:Antitubercular Agents
keywords: Aerosols; Antibiotics; Inhaled therapy; Mycobacterium tuberculosis; Pulmonary drug delivery; Tuberculosis