Abstract
ABSTRACT
Aerosol delivery of chemotherapeutic agents has been used in hopes of first, focusing therapy to the sight of the pulmonary infection with potentially higher levels of the therapeutic agent than may be achieved by systemic administration, and second, decreasing the chance of systemic side effects and toxicity. Therapy with aerosolized antibiotics has included mainly aminoglycosides, cephalosporins, penicillins, and polypeptides. The major clinical arena for the use of aerosolized antibiotic therapy has been treatment of patients with cystic fibrosis. Controlled studies of various regimens of antibiotics alone or in conjunction with parenteral therapy in cystic fibrosis patients have shown variable results in terms of the improvement in the patient's clinical status and pulmonary function. Antiviral agents which have been studied when administered by aerosol include amantadine, rimantadine, and ribavirin. The only aerosolized antiviral agent currently approved for therapeutic use is ribavirin for the treatment of infections from respiratory syncytial virus. This agent has been shown in controlled studies to be beneficial in the treatment of infants hospitalized with lower respiratory tract disease from respiratory syncytial virus. The small particle aerosol is administered for prolonged periods, 12 to 18 hours per day for an average of 3-5 days. No adverse effects or toxicity have been noted, but currently this form of therapy requires hospitalization.
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