Liposome-encapsulated aminoglycosides in pre-clinical and clinical studies

Liposome-encapsulated amikacin has recently entered clinical trials. The rationale for liposome encapsulation of aminoglycosides is the possibility to increase the therapeutic index of this class of antibiotics by increasing aminoglycoside concentrations at the site of infection and/or by reducing the toxicity of these drugs. Three approaches can be distinguished: the use of liposomes as a depot formulation for local drug administration; targeting of (relatively) short circulating conventional liposomes to the cells of the mononuclear phagocyte system (MPS) for treating intracellular bacterial infections; and targeting of long-circulating liposomes to infectious foci localized outside the MPS. This review discusses the pre-clinical and clinical data in connection with recent developments in liposome technology.