Dry powder inhalation of antibiotics

A promising approach for treatment of infectious diseases

In the thesis of Marcel Hoppentocht the feasibility to treat bacterial infections effectively with inhaled dry powder antibiotics is explored. Re-designing the basic Twincer® concept into a new device named Cyclops enabled effective delivery of aminoglycosides (tobramycin, amikacin and kanamycin) without using an excess of excipients and complex particle engineering techniques for the drug formulation. Promising results of a first patient study with the developed formulation-device combination are presented and they show the way to new and better treatments for bacterial infections.

Most antibiotics are currently administered pulmonary by wet nebulisation or via the parenteral route and both methods have numerous disadvantages. For instance, needle fear and the need for ‘cold chain storage’ of the drug solution are major drawbacks of parenteral administration. Nebulisation is time-consuming, it requires electricity or pressurised air and this, in addition to their size, makes nebulisers not very portable. Cleaning and disinfection of nebulisers burden patients particularly and this results in poor compliance with the instructions for use of their equipment and negatively affects the therapy. In the thesis, dry powder inhalation is presented as an alternative and current developments and strategies for inhaled dry powder antibiotics in tuberculosis therapy are critically evaluated in relation to the technological challenges, safety and practical needs. A new strategy is presented based on the philosophy to keep the inhaler simple and cheap, but safe and effective and for this approach new inhaler technology has been developed based on the Twincer® high dose, disposable inhaler with air classifier technology.