Nebulized liposomal amikacin for the treatment of Pseudomonas aeruginosa infection in cystic fibrosis patients

Introduction: Chronic lung infection with Pseudomonas aeruginosa (PsA) is associated with more-rapid pulmonary decline and acute pulmonary exacer-bations in patients with cystic fibrosis (CF). The treatment and eradication of this organism from CF airways is particularly difficult, making it the focus of many therapeutic endeavors. Inhaled antibiotics used for PsA treatment help to suppress growth of the organism, maintain lung function and reduce the frequency of pulmonary exacerbations. Areas covered: Herein, the authors discuss the currently available inhaled antibiotics for management of lung infections in CF patients. They also describe the recent results from clinical trials of agents under development, with a focus on liposomal amikacin for inhalation (LAI, Arikace (TM)). The article also provides a summary of the results from relevant articles published in the English. Expert opinion: LAI is a unique formulation of amikacin that enhances drug delivery and retention in CF airways via incorporation into neutral liposomes. Results of a recent Phase II trial suggest that LAI, with the capacity for once-daily dosing and prolonged off-drug periods, may be an attractive choice of inhaled antibiotic to manage PsA lung infections in CF patients. Further data from Phase III studies assessing the efficacy and safety of LAI should better elucidate its potential.