{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:14:59Z","timestamp":1791234899914,"version":"4.1.0"},"reference-count":93,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The use of inhaled antibiotics was initially almost exclusively confined to patients with cystic fibrosis (CF). However, it has been extended in recent decades to patients with non-CF bronchiectasis or chronic obstructive pulmonary disease who present with chronic bronchial infection by potentially pathogenic microorganisms. Inhaled antibiotics reach high concentrations in the area of infection, which enhances their effect and enables their long-term administration to defeat the most resistant infections, while minimizing possible adverse effects. New formulations of inhaled dry powder antibiotics have been developed, providing, among other advantages, faster preparation and administration of the drug, as well as avoiding the requirement to clean nebulization equipment. In this review, we analyze the advantages and disadvantages of the different types of devices that allow the inhalation of antibiotics, especially dry powder inhalers. We describe their general characteristics, the different inhalers on the market and the proper way to use them. We analyze the factors that influence the way in which the dry powder drug reaches the lower airways, as well as aspects of microbiological effectiveness and risks of resistance development. We review the scientific evidence on the use of colistin and tobramycin with this type of device, both in patients with CF and with non-CF bronchiectasis. Finally, we discuss the literature on the development of new dry powder antibiotics.<\/jats:p>","DOI":"10.3390\/jcm12103577","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T02:00:27Z","timestamp":1684720827000},"page":"3577","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Efficacy and Safety of Dry Powder Antibiotics: A Narrative Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0753-1771","authenticated-orcid":false,"given":"David","family":"de la Rosa-Carrillo","sequence":"first","affiliation":[{"name":"Respiratory Department, Hospital de la Santa Creu I Sant Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Su\u00e1rez-Cuart\u00edn","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital de Bellvitge, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriol","family":"Sibila","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital Cl\u00ednic i Provincial, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3759-5322","authenticated-orcid":false,"given":"Rafael","family":"Golpe","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital Lucus Augusti, 27003 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7094-0848","authenticated-orcid":false,"given":"Rosa-Mar\u00eda","family":"Gir\u00f3n","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital de la Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7321-1891","authenticated-orcid":false,"given":"Miguel-\u00c1ngel","family":"Mart\u00ednez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.arbres.2021.11.003","article-title":"Treating Neutrophilic Inflammation in Airways Diseases","volume":"58","author":"Long","year":"2022","journal-title":"Arch. 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