Inhaled antibiotics: potential and pitfalls

The administration of inhaled antibiotics represents two somewhat baffling and contradictory directions in bronchiectasis. Inhaled antibiotics have a strong appeal for the treatment of lower respiratory tract infections because they directly target the lower airways, allow high local drug concentrations well above bacterial microbe MICs, have demonstrated efficacy in cystic fibrosis, and avoid high systemic absorption and toxicities. Yet, in spite of many years of careful investigation, no inhaled antibiotic has shown proof-of-concept in pivotal Phase 3 clinical trials nor been approved by regulatory authorities…