TY - JOUR
TI - Low penetrance of antibiotics in the epithelial lining fluid. The role
of inhaled antibiotics in patients with bronchiectasis
AU - Karampitsakos, Theodoros
AU - Papaioannou, Ourania
AU - Kaponi, Maria and
AU - Kozanidou, Andreana
AU - Hillas, Georgios
AU - Stavropoulou, Elisavet and
AU - Bouros, Demosthenes
AU - Dimakou, Katerina
JO - Pulmonary Pharmacology and Therapeutics
PY - 2020
VL - 60
TODO - null
SP - null
PB - ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD
SN - null
TODO - 10.1016/j.pupt.2019.101885
TODO - Epithelial lining fluid; Bronchiectasis; Inhaled antibiotics; Treatment
TODO - Plasma 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 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 bronchiectasis. This
review article intends to summarize the current state of knowledge for
the penetrance of antibiotics in the epithelial lining fluid and present
results from clinical trials of inhaled antibiotics in patients with
bronchiectasis of etiology other than cystic fibrosis.
ER -