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JAC Advance Access published online on March 10, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki027
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JAC © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved

Review

Antitubercular inhaled therapy: opportunities, progress and challenges

Rajesh Pandey 1 and G. K. Khuller 1*

1 Department of Biochemistry, Postgraduate Institute of Medical Education & Research, Chandigarh--160 012, India

* To whom correspondence should be addressed.
G. K. Khuller, E-mail: gkkhuller{at}yahoo.co.in


  Abstract

Pulmonary tuberculosis remains the commonest form of this disease and the development of methods for delivering antitubercular drugs directly to the lungs via the respiratory route is a rational therapeutic goal. The obvious advantages of inhaled therapy include direct drug delivery to the diseased organ, targeting to alveolar macrophages harbouring the mycobacteria, reduced risk of systemic toxicity and improved patient compliance. Research efforts have demonstrated the feasibility of various drug delivery systems employing liposomes, polymeric microparticles and nanoparticles to serve as inhalable antitubercular drug carriers. In particular, nanoparticles have emerged as a remarkably useful tool for this purpose. While some researchers have preferred dry powder inhalers, others have emphasized nebulization. Beginning with the respiratory delivery of a single antitubercular drug, it is now possible to deliver multiple drugs simultaneously with a greater therapeutic efficacy. More experience and expertise have been observed with synthetic polymers, nevertheless, the possibility of using natural polymers for inhaled therapy has yet to be explored. Several key issues such as patient education, cost of treatment, stability and large scale production of drug formulations, etc. need to be addressed before antitubercular inhaled therapy finds its way from theory to clinical reality.

Keywords: tuberculosis; liposomes, polymers; nebulization; drug delivery.
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