Table 4.
Aerosol studies with macrolides, quinolones, and tetracyclines
| Reference | Drug | Subject | Production system | Result | Dosage | LFTs | Major adverse effects |
|---|---|---|---|---|---|---|---|
| Tsivkovskii et al83 | Aerosol levofloxacin MP-376 | HBE135 cells | Under clinical evaluation | Reduction in IL-6 and IL-8 | – | – | – |
| King et al54 | Levofloxacin, ciprofloxacin, amikacin, tobramycin, aztreonam | PA, BC, SM, AX, SA | – | Levofloxacin most potent MIC50 range from 8–32 μg/mL | Dosage as instructed in package | – | – |
| Peterson et al85 | Levofloxacin, ciprofloxacin | BA, YP, FT | – | Effective dosage 90–120 mg/kg/day for both quinolones | 5% levofloxacin 2% ciprofloxacin in 5% dextrose | – | – |
| Ong et al58 | Liposomal ciprofloxacin | Calu-3 | PARI LC Sprint and PARI Turbo Boy S compressor |
Slower drug release from liposomes due to absence of in vivo trigger mechanisms | Ciprofloxacin 50 mg/mL, pH 6.0, HSPC 70.6 mg/mL, cholesterol 29.4 mg/mL | – | – |
| Togami et al21 | Clarithromycin | Rat model | Liquid microsprayer | Aerosol more efficient delivery to ELF and AMs | Aerosol 0.2 mg/kg, Oral 50 mg/kg | – | – |
| Ren et al102 | Doxycycline | Rats | Electric nebulizer | Prophylactic effect against treatment of smoking-induced mucus hypersecretion | Aerosol doxycycline 20 mg/kg | – | – |
| Zhang et al67 | Azithromycin dry powder | In vitro In vivo |
Microsprayer | High encapsulation 59.2% 3.82 μm | AZI, raw material purity 95.5% | – | – |
| Nemec et al106 | Clindamycin | Mice, TNF-α, sTNFRI-sTNFR2, IL-Iβ, IL-6, PG | Microsprayer | Clindamycin alone better than clindamycin plus dexamethasone Normalized TNF-α, sTNFRs | Clindamycin 40 mg/kg | – | – |
| Togami et al91 | Telithromycin | Rats, Hemophilus influenzae, Streptococcus pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, and Mycobacterium avium S. pneumoniae resistant to Penicillin G, erythromycin A and levofloxacin | Microsprayer | Aerosol distribution more efficient in AMs and ELF | Aerosol 0.2 mg/kg, Oral 50 mg/kg | – | – |
Abbreviations: AMs, alveolar macrophages; ELF, epithelial lung fluid; TNF-α, tumor necrosis factor-α; MIC, minimum inhibitory concentration; SA, Staphylococcus aureus; PA, Pseudomona aeruginosa; BC, Burkholderia cepacia complex; SM, Stenotrophomonas maltophila; AX, Alcaligenes xylosoxidans; 1L-1β, interleukin 1β; 1L-6, interleukin 6; BA, Bacillus anthracis; YP, Yersinia pestis; FT, Francisella tularensis; Calu-3, sub-bronchial epithelial cell line; HBE135 cells, human bronchial epithelial cells; LFTs, lung function tests.