Nebulizer Therapy in Pulmonology: Review of the Literature

The lung is a very attractive target for drug delivery. Currently, as direct access for the treatment of lower respiratory diseases. Possibly, in the future, as the route of administration for systemic therapies. Nebulizers are widely used throughout the world in adult and padiatric medical practice. They are used for the management of acute bronchoconstriction both at home and in hospital, but also for long-term home treatment of various lower respiratory diseases, mainly in elderly and in infants. Overall, bronchodilators are the first class of drugs used by nebulization. The efficiency of the nebulizer has to be assured mainly for suspension, such as corticosteroids, and hyperviscous solution, such as antimicrobials, which aerolize with more difficulties with respect to bronchodilators. Unfortunately, knowledge on the optimal use of nebulizers is limited. Guidelines on best nebulizer practice are often lacking. There is a need to establish some guidance for both the drug and nebulizer manufacturers and prescribing physicians for optimization of nebulizer therapy, individuating not only drugs, dosing and administration schedule, but also the effective nebulizer system and the method for its optimal use and maintenance.