Inhalation of antibiotics in the treatment of bronchopulmonal infection

Abstract

An analysis of the current treatment protocol for lower respiratory tract infection using inhaled antibiotics is presented. Information about the pathophysiology and features of pathogens of bronchopulmonary infection in patients suffering from cystic fibrosis, nosocomial pneumonia, chronic obstructive pulmonary disease, and bronchiectasis of various etiologies is considered. The advantages and applications of inhaled antibiotics in the treatment of this category of patients are discussed. It has been established that acute and chronic infectious diseases of the lower respiratory tract are often the cause of severe human diseases and one of the leading causes of infectious mortality worldwide. Early initiation of adequate antibiotic therapy, especially in patients with a tendency to develop chronic inflammation, improves disease prognosis. However, mortality and the resistance of pathogens in this category of patients remain high. Traditional oral or parenteral antibiotic therapy does not achieve bactericidal concentrations in the lungs. Increasing dosages and combining antibiotics increases the likelihood of toxicity, superinfection, and resistance and causes undesirable side effects. Inhalation of antibiotics allows the delivery of higher concentrations directly to the lesion, thereby affecting the causative agents of the infectious process effectively while minimizing potential systemic toxicity. The large surface area of the alveoli and the thin epithelial layer provide a favorable environment for the deposition of inhaled drugs. Acute and chronic gram-negative bronchial infection caused by certain types of opportunistic microorganisms causes chronic inflammation, which leads to airway remodeling, damage to local defense mechanisms, further persistence of respiratory pathogens, and the formation of antibiotic resistance. In these cases, the use of inhaled forms of antibiotics has significant advantages in terms of effectiveness, stabilizing lung function and reducing the frequency of hospitalization, which improves quality of life and the need for systemic antibiotic therapy, reduces the risk of side effects, and reduces the cost of treatment. The results of the work can be useful for both therapists and pulmonologists.

Keywords

antibiotic therapy / bronchiectasis / gram-negative infection / inhaled antibiotics / cystic fibrosis / severe pneumonia / nosocomial pneumonia / Sievert – Kartagener syndrome / chronic obstructive pulmonary disease

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Gembitskaya T.E., Kharitonov M.A., Chermensky A.G., Chugunov A.A., Kitsyshin V.P., Zdybko A.S.