The quest to deliver high-dose rifampicin : can the inhaled approach help?

INTRODUCTION: Tuberculosis (TB) is a global health problem that poses a challenge to global treatment programs. Rifampicin is a potent and highly effective drug for TB treatment; however, higher oral doses than the standard dose (10 mg/kg/day) rifampicin may offer better efficacy in TB treatment.

AREAS COVERED: High oral dose rifampicin is not implemented in anti-TB regimens yet and requires about a 3-fold increase in dose for increased efficacy. We discuss inhaled delivery of rifampicin as an alternative or adjunct to oral high-dose rifampicin. Clinical results of safety, tolerability, and patient compliance with antibiotic dry powder inhalers are reviewed.

EXPERT OPINION: Clinical trials suggest that an approximately 3-fold increase in the standard oral dose of rifampicin may be required for better clinical outcomes. On the other hand, animal studies suggest that inhaled rifampicin can deliver a high concentration of the drug to the lungs and achieve approximately double the plasma concentration than that from oral rifampicin. Clinical trials on inhaled antibiotics suggest that dry powder inhalation is a patient-friendly and well-tolerated approach in treating respiratory infections compared to conventional treatments. Rifampicin, a well-known anti-TB drug given orally, is a good candidate for clinical development as a dry powder inhaler.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:21

Enthalten in:

Expert opinion on drug delivery - 21(2024), 1 vom: 01. Jan., Seite 31-44

Sprache:

Englisch

Beteiligte Personen:

Khadka, Prakash [VerfasserIn]
Dummer, Jack [VerfasserIn]
Hill, Philip C [VerfasserIn]
Das, Shyamal C [VerfasserIn]

Links:

Volltext

Themen:

Antitubercular Agents
Clinical trial
DPI
Dry powder inhaler
High dose rifampicin
Journal Article
Review
Rifampicin
Rifampin
Safety
Tolerability
Tuberculosis
VJT6J7R4TR

Anmerkungen:

Date Completed 02.02.2024

Date Revised 02.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/17425247.2024.2301931

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366706926