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Muco-penetrating approaches that have made it to the clinic include PEGylated adrenomedullin (NCT04417036, phase II of BAY1097761 for acute respiratory distress syndrome), amikacin liposomes (FDA-approved for mycobacterium infections therapy) and ciprofloxacin liposomes (NCT02104245, phase III of ciprofloxacin liposomes for non-cystic fibrosis bronchiectasis), all showing better penetration and retention in the airways during delivery (Table 3)
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Injectable treatments should only be considered under qualified medical supervision where there is a genuine clinical reason and appropriate safety procedures are in place
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