Biography:

Joseph L. Mathew is Professor of Pediatric Pulmonology at the Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. He has expertise in three areas viz pediatric respiratory diseases, vaccination/immunization of public health importance, and evidence-based health-care decision-making.

During the past two decades, Dr. Mathew has contributed extensively to further the understanding of the management of childhood asthma, tuberculosis, cystic fibrosis and pneumonia. He has led several research projects and published extensively in these areas. He has also contributed to evidence-based policy-making for several respiratory conditions as well as vaccination of public health importance in the context of developing countries. Dr. Mathew developed the KNOW ESSENTIALS tool for evidence-informed decision-making in resource-limited settings. He has over 200 peer-reviewed publications to his credit and delivered numerous presentations in national and international meetings. Dr. Mathew serves on several WHO Commitees, scientific committees of International societies and national Pediatrics committees.

Abstract:

Inhalational antibiotic therapy is an attractive option for specific respiratory conditions. An ideal agent should: reach the target site (lungs/ lower airways) efficiently without inducing cough or bronchospasm, penetrate infected secretions in the airway, not be absorbed systemically, be simple to administer, not foster antimicrobial resistance and be affordable. Although these requirements are not fulfilled by most antimicrobials, several antibiotics as well a few antiviral and antifungal agents have been tried in children.

Pharmacokinetics of inhaled antibiotics depends on the physico-chemical properties, formulation (in terms of respired particle size), delivery device, status of the airway (anatomy and physiology), and efficacy of airway clearance mechanisms. Although sputum concentrations of inhaled antibiotics have been traditionally measured, these are highly variable and often unreliable.