Liposomal ciprofloxacin formulations with activity against non-tuberculous mycobacteria
Methods of treatment of NTM lung infections using formulations of liposomal ciprofloxacin. Specific liposome formulations and delivery of such for treatment of respiratory tract infections and other medical conditions, and devices and formulations used in connection with such are described.
1. A method of treating a non-tuberculous mycobacteria infection, comprising:
aerosolizing a dose of a formulation to produce aerosolized particles having an aerodynamic diameter in a range of from 1 micron to 12 microns;
inhaling the aerosolizing particles into lungs of a patient, wherein the aerosolized formulation is comprised of:
a liquid carrier:
ciprofloxacin at a concentration of 20 mg/mL to 80 mg/mL encapsulated into liposomes; and
free unencapsulated ciprofloxacin in solution in the liquid carrier,
wherein the liposomes are subjected to freezing to −20° C to −80° C, followed by thawing, resulting in formation of nanocrystals of ciprofloxacin encapsulated inside the liposomes, and
wherein the non-tuberculous mycobacteria are selected from the group consisting of Mycobacterium avium, Mycobacterium abscessus, Mycobacterium avium complex, (MAC) ( Mycobacterium avium and Mycobacterium intracellulare ), Mycobacterium Bolletti, Mycobacterium chelonae, Mycobacterium ulcerans, Mycobacterium xenopi, Mycobacterium kansasii, Mycobacterium fortuitum complex ( Mycobacterium fortuitum and Mycobacterium chelonae ) and Mycobacterium marinum infections.
2. The method of claim 1 , wherein the aerosolized particles have an aerodynamic diameter of two microns to eight microns, the liposomes have a diameter of 20 nanometers to 1 micron and the nanocrystals have dimensions of 10 nanometers or less; and
wherein the ciprofloxacin is present in the solution at a concentration of 40 mg/mL to 60 mg/mL; and further wherein the liposomes are unilamellar and maintain structural integrity at a level of 90% or more after aerosolizing.
3. The method of claim 1 , further comprising:
repeating the aerosolizing and inhaling once each day over a period of at least seven days and wherein the infection is in a biofilm.
4. The method of claim 3 , further comprising:
assaying the patient for infection;
continuing the repeating of the aerosolizing and inhaling when the patient tests positive and discontinuing when the patient tests negative.
5. The method of claim 1 , wherein the liposomes are comprised of a cryopreservative and a surfactant, and wherein 95% or more of the liposomes maintain structural integrity and continue to encapsulate nanocrystals of ciprofloxacin after aerosolizing the formulation.
6. The method of claim 5 , wherein 98% or more of the liposomes maintain structural integrity and continue to encapsulate nanocrystals of ciprofloxacin after aerosolizing the formulation.
7. The method of claim 1 , wherein the non-tuberculous mycobacteria are selected from the group consisting of Mycobacterium avium and Mycobacterium abscessus.
8. The method of claim 1 , wherein the liposomes are comprised of a cryopreservative and a surfactant, and wherein 80% or more of the liposomes maintain structural integrity and continue to encapsulate nanocrystals of ciprofloxacin after aerosolizing the formulation.
9. The method of claim 1 , wherein 90% or more of the liposomes maintain structural integrity and continue to encapsulate nanocrystals of ciprofloxacin after aerosolizing the formulation.