Low penetrance of antibiotics in the epithelial lining fluid. Experience from the use of inhaled antibiotics in patients with non CF-bronchiectasis

Publication date: Available online 28 December 2019Source: Pulmonary Pharmacology & TherapeuticsAuthor(s): Theodoros Karampitsakos, Ourania Papaioannou, Maria Kaponi, Andreana Kozanidou, Georgios Hillas, Elisavet Stavropoulou, Demosthenes Bouros, Katerina DimakouAbstractPlasma drug concentrations, spectrum of antibacterial activity and minimum inhibitory concentration (MIC) had been widely considered as markers of the efficacy of antibiotics. Nonetheless, in several cases, antibiotics characterized by all these features were ineffective for the treatment of respiratory tract infections. A typical paradigm represented the case of patients with non-CF bronchiectasis who do not always benefit from antibiotics and thus experiencing increased sputum production, worse quality of life, more rapid forced expiratory volume in the first second (FEV1) decline, more frequent exacerbations and increased mortality rates, especially those with Pseudomonas aeruginosa (P. aeruginosa) chronic infection. Subsequently, penetrance of antibiotics in the epithelial lining fluid has gradually emerged as another key factor for the outcome of antibiotic treatment. Given that a plethora of antibiotics presented with poor or intermediate penetrance in the epithelial lining fluid, inhaled antibiotics targeting directly the site of infection emerged as a new option for patients with respiratory disorders including patients with non-CF bronchiectasis. This review article intends to summarize the current st...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research