Inhalable Antimicrobials for Treatment of Bacterial Biofilm-Associated Sinusitis in Cystic Fibrosis Patients: Challenges and Drug Delivery Approaches

• Published in: International journal of molecular sciences 2016-10, Vol.17 (10), p.1688-1688
• Main Authors: Kłodzińska, Sylvia Natalie, Priemel, Petra Alexandra, Rades, Thomas, Mørck Nielsen, Hanne
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Anti-Infective Agents - chemistry; Anti-Infective Agents - pharmacology; Anti-Infective Agents - therapeutic use; Antimicrobial agents; Bacteria; biofilm; Biofilms - drug effects; Biofilms - growth & development; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - pathology; devices; Drug Carriers - chemistry; Drug Compounding; drug delivery; Drug delivery systems; formulation design; Humans; inhalable drugs; Pseudomonas aeruginosa; Pseudomonas aeruginosa - physiology; Review; Sinuses; sinusitis; Sinusitis - complications; Sinusitis - drug therapy; Sinusitis - microbiology
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms17101688

Bacterial biofilm-associated chronic sinusitis in cystic fibrosis (CF) patients caused by infections and the lack of available treatments for such infections constitute a critical aspect of CF disease management. Currently, inhalation therapies to combat infections in CF patients are focused mainly on the delivery of antimicrobials to the lower respiratory tract, disregarding the sinuses. However, the sinuses constitute a reservoir for growth, leading to re-infection of the lungs, even after clearing an initial lung infection. Eradication of from the respiratory tract after a first infection has been shown to delay chronic pulmonary infection with the bacteria for up to two years. The challenges with providing a suitable treatment for bacterial sinusitis include: (i) identifying a suitable antimicrobial compound; (ii) selecting a suitable device to deliver the drug to the sinuses and nasal cavities; and (iii) applying a formulation design, which will mediate delivery of a high dose of the antimicrobial directly to the site of infection. This review highlights currently available inhalable antimicrobial formulations for treatment and management of biofilm infections caused by and discusses critical issues related to novel antimicrobial drug formulation design approaches.