Antimicrobial Molecules in the Lung: Formulation Challenges and Future Directions for Innovation

Woods, Arcadia; Rahman, Khondaker Miraz

doi:10.4155/fmc-2017-0162

Cited by 15 publications

(10 citation statements)

References 177 publications

(204 reference statements)

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“…The market makes available some formulations of inhaled antibiotics, including tobramycin, colistin and aztreonan, which are mainly directed to the treatment of infections associated with cystic fibrosis conditions [66]. Other applications have been reported occasionally, such as the use of aerosolized antibiotics in hospital-acquired pneumonia [67].…”

Section: Delivery Of Antibioticsmentioning

confidence: 99%

“…Other applications have been reported occasionally, such as the use of aerosolized antibiotics in hospital-acquired pneumonia [67]. Research in the area has been increasing consistently, and a recent review on inhalable antibiotic formulations is available in [66]. Along with the discovery of new antibiotics, the development of delivery systems to improve the therapeutic performance of the molecules has been object of scientific efforts and both approaches are, in fact, effective countermeasures against antibiotic resistance.…”

Section: Delivery Of Antibioticsmentioning

confidence: 99%

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Multifunctional Nanocarriers for Lung Drug Delivery

Pontes

Grenha

2020

Nanomaterials

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Nanocarriers have been increasingly proposed for lung drug delivery applications. The strategy of combining the intrinsic and more general advantages of the nanostructures with specificities that improve the therapeutic outcomes of particular clinical situations is frequent. These include the surface engineering of the carriers by means of altering the material structure (i.e., chemical modifications), the addition of specific ligands so that predefined targets are reached, or even the tuning of the carrier properties to respond to specific stimuli. The devised strategies are mainly directed at three distinct areas of lung drug delivery, encompassing the delivery of proteins and protein-based materials, either for local or systemic application, the delivery of antibiotics, and the delivery of anticancer drugs—the latter two comprising local delivery approaches. This review addresses the applications of nanocarriers aimed at lung drug delivery of active biological and pharmaceutical ingredients, focusing with particular interest on nanocarriers that exhibit multifunctional properties. A final section addresses the expectations regarding the future use of nanocarriers in the area.

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Section: Delivery Of Antibioticsmentioning

confidence: 99%

Section: Delivery Of Antibioticsmentioning

confidence: 99%

Multifunctional Nanocarriers for Lung Drug Delivery

Pontes

Grenha

2020

Nanomaterials

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“…The technology has been used in the TOBI Podhaler device (Novartis Pharmaceuticals, Basel, Switzerland), which is used for delivering tobramycin for the treatment of infections caused by Pseudomonas aeruginosa in patients with cystic fibrosis. Indeed, antimicrobial therapy is one area that has benefitted from extensive recent research and development in inhaled drug delivery to the lungs [48]. It offers the opportunity to achieve high doses of antibiotics directly at the site of infection, without requiring potentially toxic high systemic concentrations, reducing the number of cellular barriers that must be negotiated by the molecule before reaching the bacterial infection.…”

Section: What Are the Current Incentives Driving Inhaler Development mentioning

confidence: 99%

“…Lung concentrations up to 30 times higher than those measured following intravenous administration can be achieved by inhalation [49]. Besides tobramycin, formulations of colistin, aztreonam and levofloxacin have been approved for the treatment of lung infections in cystic fibrosis, and several other classes are in development [48]. …”

Section: What Are the Current Incentives Driving Inhaler Development mentioning

confidence: 99%

Is there room for further innovation in inhaled therapy for airways disease?

Biddiscombe

Usmani

2018

Breathe

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Inhaled medication is the cornerstone in the treatment of patients across a spectrum of respiratory diseases including asthma and chronic obstructive pulmonary disease. The benefits of inhaled therapy have long been recognised but the most important innovations have occurred over the past 60 years, beginning with the invention of the pressurised metered dose inhaler. However, despite over 230 different device and drug combinations currently being available, disease control is far from perfect.Here we look at how innovation in inhaler design may improve treatments for respiratory diseases and how new formulations may lead to treatments for diseases beyond the lungs. We look at the three main areas where innovation in inhaled therapy is most likely to occur: 1) device engineering and design; 2) chemistry and formulations; and 3) digital technology associated with inhalers. Inhaler design has improved significantly but considerable challenges still remain in order to continually innovate and improve targeted drug delivery to the lungs. Healthcare professionals want see innovations that motivate their patients to achieve their goal of improving their health, through better adherence to treatment. Patients want devices that are easy to use and to see that their efforts are rewarded by improvements in their condition.Key pointsThe dictionary definition of innovation is the introduction of new things, ideas or ways of doing something. We show how this definition can be applied to inhaled therapy.We take a look at the past to see what drove innovation in inhaler design and how this has led to the current devices.We look at the current drivers of innovation in engineering, chemistry and digital technology and predict how this may translate to new devices.Can innovation help the healthcare professional manage their patients better?What does the patient expect from innovation in their device?Educational aimsTo understand the importance of inhaled medication in the treatment of lung diseases.To understand how innovation has helped advance some of the devices patients use today from basic and inefficient designs.To understand the obstacles that prevent patients from receiving optimal treatment from their inhalers.To understand how innovation in inhaler design can lead to improved treatment for patients and widen the range of diseases that can be treated via the inhaled route.

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“…People with CF inhale antibiotics regularly as a chronic, suppressive therapy against persistent bacterial infection. This achieves high drug concentration at the site of infection (i.e., in the airway) without the high systemic exposure and associated risks of systemic side effects when administered enterally or intravenously (6). Prospective clinical trials and long-term observational studies have demonstrated relatively low risks of serious side effects from even years of intermittent inhaled antibiotic therapy, which is now the standard of care in the United States (7).…”

mentioning

confidence: 99%