{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:39:31Z","timestamp":1787582371712,"version":"build-2736575974"},"reference-count":162,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Lower respiratory tract infections caused by Pseudomonas aeruginosa are a global concern. Patients with chronic lung diseases such as cystic fibrosis and non-cystic fibrosis bronchiectasis often do not receive adequate antibiotic delivery through conventional routes. P. aeruginosa employs several mechanisms, including biofilm formation and efflux pumps to limit the accumulation of bactericidal drug concentrations. Direct drug delivery to the lung epithelial lining fluid can increase antibiotic concentration and reduce treatment failure rates. This review discusses current research and developments in inhaled antibiotic formulations for treating P. aeruginosa infections. Recent studies on particle engineering for the dry powder inhalers of antibiotics emphasized three fundamental principles of development: micro, nano, and nano-in-microparticles. Carrier-free microparticles showed potential for high-dose delivery but suffered from poor aerosolization, which could be improved through a drug\u2013drug combination. Amino acids in a co-spray-dried system improved powders\u2019 aerodynamics and reduced moisture sensitivity while incorporating the chitosan\/poly(lactic-co-glycolic acid) (PLGA)-modified release of the drug. Nano-in-microsystems, embedding lipid carriers, showed improved antibiofilm activity and controlled release. We also highlight emerging biologics, including antibacterial proteins\/peptides, vaccines, bacteriophages, and probiotics. Research on antibiotics and biologics for inhalation suggests excellent safety profiles and encouraging efficacy for some formulations, including antimicrobial peptides and bacteriophage formulations. Further research on novel molecules and synergistic biologic combinations, supported by comprehensive animal lung safety investigations, will be required in future developments.<\/jats:p>","DOI":"10.3390\/pharmaceutics18020162","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T15:48:30Z","timestamp":1769442510000},"page":"162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Inhaled Antibiotic and Biologic Formulations Targeting Pseudomonas aeruginosa"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0569-1763","authenticated-orcid":false,"given":"Prodip Kumar","family":"Baral","sequence":"first","affiliation":[{"name":"School of Pharmacy, Faculty of Health Professional Programmes, University of Otago, Dunedin 9054, New Zealand"},{"name":"Department of Microbiology and Immunology, Faculty of Biomedical Sciences, University of Otago, Dunedin 9054, New Zealand"},{"name":"Department of Pharmacy, Noakhali Science and Technology University, Noakhali 3814, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1581-6857","authenticated-orcid":false,"given":"Jack","family":"Dummer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, University of Otago, Dunedin 9054, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-7505","authenticated-orcid":false,"given":"Daniel","family":"Pletzer","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Biomedical Sciences, University of Otago, Dunedin 9054, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-8147","authenticated-orcid":false,"given":"Shyamal C.","family":"Das","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Health Professional Programmes, University of Otago, Dunedin 9054, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107042","DOI":"10.1016\/j.rmed.2022.107042","article-title":"Global Morbidity and Mortality of Lower Respiratory Infections: A Population-Based Study","volume":"205","author":"Yang","year":"2022","journal-title":"Respir. 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