Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives
Although new inhaled antibiotics have profoundly improved respiratory diseases in cystic fibrosis (CF) patients, lung infections are still the leading cause of death. Inhaled antibiotics, i.e., colistin, tobramycin, aztreonam lysine and levofloxacin, are used as maintenance treatment for CF patients...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/3/338 |
| _version_ | 1827696963443752960 |
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| author | Giovanni Taccetti Michela Francalanci Giovanna Pizzamiglio Barbara Messore Vincenzo Carnovale Giuseppe Cimino Marco Cipolli |
| author_facet | Giovanni Taccetti Michela Francalanci Giovanna Pizzamiglio Barbara Messore Vincenzo Carnovale Giuseppe Cimino Marco Cipolli |
| author_sort | Giovanni Taccetti |
| collection | DOAJ |
| description | Although new inhaled antibiotics have profoundly improved respiratory diseases in cystic fibrosis (CF) patients, lung infections are still the leading cause of death. Inhaled antibiotics, i.e., colistin, tobramycin, aztreonam lysine and levofloxacin, are used as maintenance treatment for CF patients after the development of chronic <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) infection. Their use offers advantages over systemic therapy since a relatively high concentration of the drug is delivered directly to the lung, thus, enhancing the pharmacokinetic/pharmacodynamic parameters and decreasing toxicity. Notably, alternating treatment with inhaled antibiotics represents an important strategy for improving patient outcomes. The prevalence of CF patients receiving continuous inhaled antibiotic regimens with different combinations of the anti-<i>P. aeruginosa</i> antibiotic class has been increasing over time. Moreover, these antimicrobial agents are also used for preventing acute pulmonary exacerbations in CF. In this review, the efficacy and safety of the currently available inhaled antibiotics for lung infection treatment in CF patients are discussed, with a particular focus on strategies for eradicating <i>P. aeruginosa</i> and other pathogens. Moreover, the effects of long-term inhaled antibiotic therapy for chronic <i>P. aeruginosa</i> infection and for the prevention of pulmonary exacerbations is reviewed. Finally, how the mucus environment and microbial community richness can influence the efficacy of aerosolized antimicrobial agents is discussed. |
| first_indexed | 2024-03-10T12:59:37Z |
| format | Article |
| id | doaj.art-05e6dfa734c3418bb84db91f5928896c |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T12:59:37Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-05e6dfa734c3418bb84db91f5928896c2023-11-21T11:33:19ZengMDPI AGAntibiotics2079-63822021-03-0110333810.3390/antibiotics10030338Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future PerspectivesGiovanni Taccetti0Michela Francalanci1Giovanna Pizzamiglio2Barbara Messore3Vincenzo Carnovale4Giuseppe Cimino5Marco Cipolli6Cystic Fibrosis Center, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Firenze, ItalyCystic Fibrosis Center, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Firenze, ItalyDepartment Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyAdult Cystic Fibrosis Center, Azienda Ospedaliera Universitaria San Luigi Gonzaga, 10043 Orbassano, ItalyAdult Cystic Fibrosis Center, Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, ItalyCystic Fibrosis Center, Policlinico Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, ItalyCystic Fibrosis Center, Azienda Ospedaliero Universitaria Integrata di Verona, Pl. Aristide Stefani 1, 37126 Verona, ItalyAlthough new inhaled antibiotics have profoundly improved respiratory diseases in cystic fibrosis (CF) patients, lung infections are still the leading cause of death. Inhaled antibiotics, i.e., colistin, tobramycin, aztreonam lysine and levofloxacin, are used as maintenance treatment for CF patients after the development of chronic <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) infection. Their use offers advantages over systemic therapy since a relatively high concentration of the drug is delivered directly to the lung, thus, enhancing the pharmacokinetic/pharmacodynamic parameters and decreasing toxicity. Notably, alternating treatment with inhaled antibiotics represents an important strategy for improving patient outcomes. The prevalence of CF patients receiving continuous inhaled antibiotic regimens with different combinations of the anti-<i>P. aeruginosa</i> antibiotic class has been increasing over time. Moreover, these antimicrobial agents are also used for preventing acute pulmonary exacerbations in CF. In this review, the efficacy and safety of the currently available inhaled antibiotics for lung infection treatment in CF patients are discussed, with a particular focus on strategies for eradicating <i>P. aeruginosa</i> and other pathogens. Moreover, the effects of long-term inhaled antibiotic therapy for chronic <i>P. aeruginosa</i> infection and for the prevention of pulmonary exacerbations is reviewed. Finally, how the mucus environment and microbial community richness can influence the efficacy of aerosolized antimicrobial agents is discussed.https://www.mdpi.com/2079-6382/10/3/338cystic fibrosis<i>P. aeruginosa</i>inhaled antibioticspulmonary exacerbations |
| spellingShingle | Giovanni Taccetti Michela Francalanci Giovanna Pizzamiglio Barbara Messore Vincenzo Carnovale Giuseppe Cimino Marco Cipolli Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives Antibiotics cystic fibrosis <i>P. aeruginosa</i> inhaled antibiotics pulmonary exacerbations |
| title | Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives |
| title_full | Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives |
| title_fullStr | Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives |
| title_full_unstemmed | Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives |
| title_short | Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives |
| title_sort | cystic fibrosis recent insights into inhaled antibiotic treatment and future perspectives |
| topic | cystic fibrosis <i>P. aeruginosa</i> inhaled antibiotics pulmonary exacerbations |
| url | https://www.mdpi.com/2079-6382/10/3/338 |
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