b9c5372d3dc9a239bb8fad99e2ac7957 301716.pdf 323893aa0aaad8b9686686661e69ad8c6eed4b64 301716.pdf 6dbc987c4e8651ded07cce20c00f3fcd30e502983cbb1e6b3ca250ce4abefbf3 301716.pdf Title: Efficacy and Safety of Dry Powder Antibiotics: A Narrative Review Subject: The use of inhaled antibiotics was initially almost exclusively confined to patients with cystic fibrosis (CF). However, it has been extended in recent decades to patients with non-CF bronchiectasis or chronic obstructive pulmonary disease who present with chronic bronchial infection by potentially pathogenic microorganisms. Inhaled antibiotics reach high concentrations in the area of infection, which enhances their effect and enables their long-term administration to defeat the most resistant infections, while minimizing possible adverse effects. New formulations of inhaled dry powder antibiotics have been developed, providing, among other advantages, faster preparation and administration of the drug, as well as avoiding the requirement to clean nebulization equipment. In this review, we analyze the advantages and disadvantages of the different types of devices that allow the inhalation of antibiotics, especially dry powder inhalers. We describe their general characteristics, the different inhalers on the market and the proper way to use them. We analyze the factors that influence the way in which the dry powder drug reaches the lower airways, as well as aspects of microbiological effectiveness and risks of resistance development. We review the scientific evidence on the use of colistin and tobramycin with this type of device, both in patients with CF and with non-CF bronchiectasis. Finally, we discuss the literature on the development of new dry powder antibiotics. Keywords: antibiotics; inhalation drug; Pseudomonas aeruginosa; chronic bronchial infection; bronchiectasis; cystic fibrosis; dry powder antibiotics Author: David de la Rosa-Carrillo, Guillermo Suárez-Cuartín, Oriol Sibila, Rafael Golpe, Rosa-María Girón and Miguel-Ángel Martínez-García Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon May 22 09:33:34 2023 CEST ModDate: Mon May 22 09:39:53 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 20 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1063173 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YWQWLZ+VnURWPalladioL Type 1 Custom yes yes no 10 0 VQCGTJ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 PERHJM+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 ISNSYH+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 WIPXQR+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 CZMDWU+CMSY10 Type 1 Builtin yes yes no 74 0 KDWCJS+PalatinoLinotype,Italic TrueType WinAnsi yes yes yes 83 0 ZETNMX+PalatinoLinotype,Bold TrueType WinAnsi yes yes yes 87 0 LVCALQ+PalatinoLinotype TrueType WinAnsi yes yes yes 91 0 KDWCJS+PalatinoLinotype,Italic TrueType WinAnsi yes yes yes 98 0 ZETNMX+PalatinoLinotype,Bold TrueType WinAnsi yes yes yes 102 0 LVCALQ+PalatinoLinotype TrueType WinAnsi yes yes yes 106 0 KDWCJS+PalatinoLinotype,Italic TrueType WinAnsi yes yes yes 120 0 ZETNMX+PalatinoLinotype,Bold TrueType WinAnsi yes yes yes 124 0 LVCALQ+PalatinoLinotype TrueType WinAnsi yes yes yes 128 0 KDWCJS+PalatinoLinotype,Italic TrueType WinAnsi yes yes yes 136 0 ZETNMX+PalatinoLinotype,Bold TrueType WinAnsi yes yes yes 140 0 LVCALQ+PalatinoLinotype TrueType WinAnsi yes yes yes 144 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 156 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-26 02:46:19 CEST RepresentationInformation: 301716.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-10-25 13:13:16 CEST Size: 1063173 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 487 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Nebulized Antibiotics: General Characteristics and Modalities Destination: section.2 Children: Item: Title: Ultrasonic Nebulizers Destination: subsection.2.1 Item: Title: Jet Nebulizers Destination: subsection.2.2 Item: Title: Mesh Nebulizers Destination: subsection.2.3 Item: Title: Dry Powder for Antibiotics Destination: section.3 Children: Item: Title: General/Technical Characteristics of the Devices Destination: subsection.3.1 Item: Title: Deposition of Lung Particles Destination: subsection.3.2 Item: Title: Microbiological Issues Destination: subsection.3.3 Item: Title: Studies with Inhaled Dry Powder Antibiotics in Cystic Fibrosis Patients Destination: section.4 Children: Item: Title: Tobramycin Studies Destination: subsection.4.1 Item: Title: Colistin Studies Destination: subsection.4.2 Item: Title: Studies with Antibiotic Dry Powder Inhalers in Bronchiectasis Destination: section.5 Item: Title: Other Dry Powder Antibiotics Destination: section.6 Children: Item: Title: Anti-Tuberculous Agents Destination: subsection.6.1 Item: Title: Ciprofloxacin Destination: subsection.6.2 Item: Title: Meropenem Destination: subsection.6.3 Item: Title: Doxycycline Destination: subsection.6.4 Item: Title: Vancomycin Destination: subsection.6.5 Item: Title: Conclusions Destination: section.7 Item: Title: References Destination: section.8 Info: Title: Efficacy and Safety of Dry Powder Antibiotics: A Narrative Review Author: David de la Rosa-Carrillo, Guillermo Suárez-Cuartín, Oriol Sibila, Rafael Golpe, Rosa-María Girón and Miguel-Ángel Martínez-García Subject: The use of inhaled antibiotics was initially almost exclusively confined to patients with cystic fibrosis (CF). However, it has been extended in recent decades to patients with non-CF bronchiectasis or chronic obstructive pulmonary disease who present with chronic bronchial infection by potentially pathogenic microorganisms. Inhaled antibiotics reach high concentrations in the area of infection, which enhances their effect and enables their long-term administration to defeat the most resistant infections, while minimizing possible adverse effects. New formulations of inhaled dry powder antibiotics have been developed, providing, among other advantages, faster preparation and administration of the drug, as well as avoiding the requirement to clean nebulization equipment. In this review, we analyze the advantages and disadvantages of the different types of devices that allow the inhalation of antibiotics, especially dry powder inhalers. We describe their general characteristics, the different inhalers on the market and the proper way to use them. We analyze the factors that influence the way in which the dry powder drug reaches the lower airways, as well as aspects of microbiological effectiveness and risks of resistance development. We review the scientific evidence on the use of colistin and tobramycin with this type of device, both in patients with CF and with non-CF bronchiectasis. Finally, we discuss the literature on the development of new dry powder antibiotics. 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