Merchant, Z, Buckton, G, Taylor, KMG, Stapleton, P, Saleem, IY, Zariwala, MG and Somavarapu, S
(2016)
A New Era of Pulmonary Delivery of Nano-antimicrobial Therapeutics to Treat Chronic Pulmonary Infections.
CURRENT PHARMACEUTICAL DESIGN, 22 (17).
pp. 2577-2598.
ISSN 1381-6128
Abstract
Pulmonary infections may be fatal especially in immunocompromised patients and patients with underlying
pulmonary dysfunction, such as those with cystic fibrosis, chronic obstructive pulmonary disorder, etc. According
to the WHO, lower respiratory tract infections ranked first amongst the leading causes of death in 2012,
and tuberculosis was included in the top 10 causes of death in low income countries, placing a considerable strain
on their economies and healthcare systems. Eradication of lower respiratory infections is arduous, leading to high
healthcare costs and requiring higher doses of antibiotics to reach optimal concentrations at the site of pulmonary
infection for protracted periods. Hence direct inhalation to the respiratory epithelium has been investigated extensively in the past decade,
and seems to be an attractive approach to eradicate and hence overcome this widespread problem. Moreover, engineering inhalation formulations
wherein the antibiotics are encapsulated within nanoscale carriers could serve to overcome many of the limitations faced by
conventional antibiotics, like difficulty in treating intracellular pathogens such as mycobacteria spp. and salmonella spp., biofilmassociated
pathogens like Pseudomonas aeruginosa and Staphylococcus aureus, passage through the sputum associated with disorders
like cystic fibrosis and chronic obstructive pulmonary disorder, systemic side effects following oral/parenteral delivery and inadequate
concentrations of antibiotic at the site of infection leading to resistance. Encapsulation of antibiotics in nanocarriers may help in providing
a protective environment to combat antibiotic degradation, confer controlled-release properties, hence reducing dosing frequency, and
may increase uptake via specific and non-specific targeting modalities. Hence nanotechnology combined with direct administration to the
airways using commercially available delivery devices, is a highly attractive formulation strategy to eradicate microorganisms from the
lower respiratory tract, which might otherwise present opportunities for multi-drug resistance.
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A New Era of Pulmonary Delivery of Nano-antimicrobial Therapeutics to Treat Chronic Pulmonary Infections. (deposited 17 Jun 2016 08:33)
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