An update on inhaled antibiotherapy in Pseudomonas aeruginosa respiratory tract infections

Inhalation of antibiotics to treat Pseudomonas aeruginosa respiratory infection has improved the prognosis of cystic fibrosis and its evolution. Clinical trials have shown the advantage of this protocol in acute exacerbation and prevention of chronic respiratory colonization by Pseudomonas aeruginosa. They give us specific protocols. No controlled trial has proved the efficiency of inhaled antibiotics for the management of nosocomial pneumonia, but the combination of aerosolized and intravenous antibiotics seems to give better results. Colimycin and tobramycin are the most efficient molecules for the local treatment of Pseudomonas aeruginosa respiratory infection. Direct aerosolized delivery of this antibiotic to the lower airway is a good rational for the use. Safety, efficacy, no emergence of bacteria resistant to colistin or tobramycin, and no overcost favor a more frequent use of aerosolized antibiotics. (C) 2002 Editions scientifiques et medicales Elsevier SAS. All rights reserved.