Abstract
Inhalation therapy has been usually used for the patients with bronchial asthma or chronic obstructive pulmonary disease. In contrast, it has not been used for respiratory tract infection except for influenza virus infection. There is a demand for antibiotic inhalation therapy, because the development of novel antibiotics is stagnant but the multidrug-resistant bacteria are increasing. Among the pathogens, P. aeruginosa has been a common cause of chronic respiratory infection and hospital-acquired pneumonia (HAP) including ventilator-associated pneumonia (VAP). Although there are several anti-pseudomonal agents, P. aeruginosa is associated with high in-hospital mortality and prolonged length of stay in hospitals. P. aeruginosa infection has been difficult to treat because the bacteria possess numerous mechanisms of antimicrobial resistance. Thus, antibiotics, such as tobramycin, colistin, and aztreonam, have been administered via inhalation to patients with chronic respiratory tract infections or HAP to maximize the drug delivery to the target site of infection and limit the potential for systemic side effects. Recently, several clinical studies reported that administration of amikacin via inhalation is effective in patients with VAP. Our previous study also demonstrated the in vivo effectiveness of arbekacin inhalation therapy in the murine model of VAP caused by P. aeruginosa. The antibiotic inhalation therapy would be the option in the patients with respiratory tract infection.
