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Int. J. Mol. Sci. 2016, 17(10), 1688; doi:10.3390/ijms17101688

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

Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
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Academic Editor: Már Másson
Received: 5 July 2016 / Revised: 5 August 2016 / Accepted: 29 August 2016 / Published: 9 October 2016
(This article belongs to the Special Issue Drug Delivery and Antimicrobial Agents)
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Abstract

Bacterial biofilm-associated chronic sinusitis in cystic fibrosis (CF) patients caused by Pseudomonas aeruginosa infections and the lack of available treatments for such infections constitute a critical aspect of CF disease management. Currently, inhalation therapies to combat P. aeruginosa 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 P. aeruginosa growth, leading to re-infection of the lungs, even after clearing an initial lung infection. Eradication of P. aeruginosa 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 P. aeruginosa and discusses critical issues related to novel antimicrobial drug formulation design approaches. View Full-Text
Keywords: biofilm; drug delivery; formulation design; devices; inhalable drugs; sinusitis; cystic fibrosis biofilm; drug delivery; formulation design; devices; inhalable drugs; sinusitis; cystic fibrosis
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Kłodzińska, S.N.; Priemel, P.A.; Rades, T.; Mørck Nielsen, H. Inhalable Antimicrobials for Treatment of Bacterial Biofilm-Associated Sinusitis in Cystic Fibrosis Patients: Challenges and Drug Delivery Approaches. Int. J. Mol. Sci. 2016, 17, 1688.

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