Inhaled aztreonam and an adapted delivery device in the treatment of cystic fibrosis

Respiratory damage in cystic fibrosis (CF) is the result of a vicious circle of chronic infection, severe inflammation, and rapidly progressing bronchial obstruction. These processes are the main cause of high mortality associated with the disease. With age, the number of patients infected with non-fermenting gram-negative microflora increases. Pseudomonas aeruginosa is the most common gram-negative pathogen infecting the respiratory tract of patients with CF. The introduction of inhaled antipseudomonal antibiotics has changed the course of the disease and improved the lives of patients. The aim. The objective of the review was to study the role of aztreonam lysine for inhalation (AZLI) in the treatment of patients with CF based on an analysis of literary sources. Methods. A search for publications on AZLI was conducted in the Cochrane Database of Systematic Reviews, as well as in the PubMed and ClinicalTrials.gov databases using the queries “inhaled aztreonam” and “cystic fibrosis”. Results. The results of pre-registration clinical placebo-controlled phase 3 studies that led to AZLI’s Food and Drug Administration (FDA) approval were found and analyzed. The review also included reports of post-marketing studies comparing AZLI with the existing “gold standard” of inhaled antibacterial therapy for CF – inhaled Tobramycin. The role of the adapted AZLI delivery device, which creates an innovative drug-delivery device combination to achieve the maximum therapeutic effect, is separately noted. Conclusion. It is concluded that the inclusion of AZLI in the treatment program for CF accompanied by P. aeruginosa infection can further improve the clinical and functional characteristics and quality of life of the patients.