Inhalable aztreonam lysinate formulation for treatment and prevention of pulmonary bacterial infections

1. An inhalable pharmaceutically acceptable composition comprising from about 1 to about 250 mg per one dose of aztreonam lysinate, said composition suitable for treatment of pulmonary bacterial infections caused by gram-negative bacteria wherein said aztreonam lysinate is prepared as an aerosolable saline solution.

2. The composition of claim 1 administered once, two, three or four times a day with a proviso that when the composition is administered more than three times a day, the total dose of the aztreonam lysinate does not exceed 750 mg a day.

3. The composition of claim 2 wherein said aztreonam lysinate is dissolved in from about 1 to about 5 ml of the aerosolable saline solution comprising at least 0.09%, w/v, of sodium chloride or equivalent amount of bromine, iodine or bicarbonate salt.

4. The composition of claim 3 wherein said aerosolable saline solution comprises from about 0.1 to about 0.45%, w/v, of sodium chloride and has pH from about 4.5 to about 7.5.

5. The composition of claim 4 wherein said aerosolable saline solution has pH from about 4.5 to about 5.5.

6. The composition of claim 5 nebulized into particles, at least 70% of which have sizes between about 1 and about 5 μm.

7. The composition of claim 6 comprising about 75 mg of aztreonam dissolved in about 1 ml of saline.

8. The composition of claim 7 wherein said aztreonam lysinate is alpha aztreonam lysinate.

9. The composition of claim 8 wherein said aztreonam lysinate has impurity lower than 1%, w/v, and stability for at least two years.

10. The composition of claim 9 wherein said aztreonam lysinate contains less than 100 ppm of alcohol and initial levels of contaminants generated from the alpha form of aztreonam are less than 1%, w/v.

11. An aerosol composition comprising from about 1 to about 250 mg of aztreonam lysinate, wherein said aztreonam lysinate is dissolved in from about 1 to about 5 ml of a saline solution containing from about 0.1 to about 0.9%, w/v, sodium chloride.

12. The aerosol of claim 11 wherein said aerosol comprises aztreonam lysinate, which consists of 75 mg of aztreonam and 47 mg of lysine, per 1 ml of saline.

13. The aerosol of claim 12 wherein said aztreonam lysinate is alpha aztreonam lysinate.

14. A method of treating pulmonary infections caused by gram-negative bacteria, said method comprising delivering an aerosol of an inhalable aztreonam lysinate formulation to the lung endobronchial space of airways of a patient in need thereof.

15. The method of claim 14 wherein said inhalable aztreonam lysinate formulation comprises from about 1 to about 250 mg of aztreonam lysinate per one dose.

16. The method of claim 15 wherein said aerosol comprises from about 1 to about 250 mg of aztreonam lysinate dissolved in about 1 to about 5 ml of a saline solution containing from about 0.1 to about 0.9%, w/v, of sodium chloride or an equivalent thereof.

17. The method of claim 16 wherein said aerosol is nebulized into particles, at least 70% of which have sizes between about 1 and about 5 μm.

18. The method of claim 17 wherein the inhalable aztreonam lysinate formulation is delivered one to twelve times a day, provided that a total dose of aztreonam lysinate is not higher than 750 mg a day.

19. The method of claim 18 wherein said aerosol is delivered by a nebulizer.

20. The method of claim 19 wherein the nebulizer is an atomizing jet, ultrasonic, electronic or vibrating porous plate nebulizer, wherein said nebulizer is able to or is modified to be able to nebulize volume from about 1 to about 5 ml of the inhalable aztreonam lysinate formulation to an aerosol having particle sizes ranging from about 1 to about 5 μm.

21. The method of claim 20 wherein the inhalable aztreonam lysinate formulation comprises from about 10 to about 200 mg of the aztreonam lysinate.

22. The method of claim 21 wherein the inhalable aztreonam lysinate formulation comprises from about 50 to about 150 mg of aztreonam lysinate.

23. The method of claim 22 wherein the aerosol has pH from about 4.5 to about 7.5 and the saline solution contains from about 0.1 to about 0.45%, w/v, of sodium chloride.

24. The method of claim 23 wherein said aerosol has pH from about 4.5 to about 5.5.

25. The method of claim 24 wherein said aztreonam lysinate is alpha aztreonam lysinate.

26. The method of claim 16 comprising administering to the patient in need thereof the aerosol comprising from about 10 to about 150 mg of the aztreonam lysinate once, twice, three or four times a day.

27. The method of claim 26 wherein said aerosol comprises aztreonam lysinate, which consists of 75 mg of aztreonam and 47 mg of lysine, per 1 ml of saline.

28. The method of claim 27 wherein the aztreonam lysinate is alpha aztreonam lysinate.

29. The method of claim 28 wherein said alpha aztreonam lysinate has impurity lower than 1%, w/v, and stability for at least two years.

30. The method of claim 29 wherein said alpha aztreonam lysinate contains less than 100 ppm of alcohol and initial levels of contaminants generated from the alpha form of aztreonam are less than 1%, w/v.

31. A method of treating infections caused by the gram-negative bacteria in patients with cystic fibrosis or bronchiectasis, or in patients on ventilators with pneumonia, comprising delivering an aerosol of an inhalable aztreonam lysinate formulation to the lung endobronchial space of airways of a patient in need thereof, wherein the inhalable aztreonam lysinate formulation comprises from about 1 to about 250 mg of aztreonam lysinate.

32. The method of claim 31 wherein said aztreonam lysinate is alpha aztreonam lysinate.

33. A method of treating pulmonary infections caused by gram-negative bacteria comprising delivering an aerosol of an inhalable aztreonam lysinate formulation to the lung endobronchial space of airways of a patient in need thereof, wherein the inhalable aztreonam formulation comprises from about 1 to about 250 mg of aztreonam lysinate dissolved in about 1 to about 5 ml of a saline solution.

34. The method of claim 33 wherein said inhalable aztreonam lysinate formulation comprises about 75 mg of aztreonam dissolved in about 1 ml of saline solution.

35. The method of claim 34 wherein said aztreonam lysinate is alpha aztreonam lysinate.

36. The method of claims 35 wherein said gram-negative bacteria is Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Pseudomonas aeruginosa, Haemophilus influenzae, Proteus mirabilis, Serratia marcescens, Burkholderia cepacia, Stenotrophomonas maltophilia, Alcaligenes xylosoxidans or multidrug resistant Pseudomonas aeruginosa.