# Pulmonary Drug Delivery for Infectious Diseases: Cutting-Edge Formulations and Manufacturing Technologies

**Authors:** Brayan J. Anaya, Emanuel Osorio-Vargas, Samir Monterrosa-Moreno, Diego F. Tirado, Elena González-Burgos, Dolores R. Serrano

PMC · DOI: 10.3390/pharmaceutics18020242 · Pharmaceutics · 2026-02-14

## TL;DR

This paper reviews advanced drug delivery methods for treating lung infections by focusing on how to design and manufacture effective inhaled therapies.

## Contribution

The paper provides a comprehensive overview of cutting-edge formulation and manufacturing technologies for pulmonary drug delivery of anti-infective therapies.

## Key findings

- Advanced particle-engineering methods like spray drying and supercritical fluid technologies are key for controlling drug particle properties.
- Nanoparticle-based systems can target specific lung cells, improving antimicrobial efficacy.
- Microfluidics and 3D printing offer new ways to enhance the uniformity and customization of inhaled drug formulations.

## Abstract

Pulmonary drug delivery has emerged as a powerful strategy for the treatment of respiratory infectious diseases, including bacterial, fungal, and viral infections such as influenza and COVID-19, by enabling high local drug concentrations while minimizing systemic exposure. However, the clinical success of inhaled anti-infective therapies critically depends on the precise engineering of particle properties that govern lung deposition, cellular targeting, and therapeutic efficacy. In this review, we provide a comprehensive and technology-driven overview of cutting-edge formulation and manufacturing strategies for pulmonary drug delivery, with particular emphasis on the key process and formulation parameters required to generate effective inhalable systems for the treatment of infectious diseases. Advanced particle-engineering approaches, including spray drying, spray freeze drying, jet milling, and supercritical fluid technologies are discussed as enabling tools to tightly control aerodynamic particle size, morphology, and solid-state properties. In parallel, emerging platforms such as nanoparticle-based delivery systems are examined for their ability to target specific lung cell populations, including epithelial cells and alveolar macrophages, thereby enhancing antimicrobial efficacy. Finally, innovative manufacturing concepts such as microfluidics and three-dimensional (3D) printing are highlighted as promising strategies to improve particle size uniformity, reproducibility, and formulation customization. By integrating formulation science with advanced manufacturing technologies, this review identifies the critical design and processing parameters that underpin effective pulmonary delivery of anti-infective therapies and outlines future directions for the development of next-generation inhaled treatments.

## Linked entities

- **Diseases:** influenza (MONDO:0005812), COVID-19 (MONDO:0100096)

## Full-text entities

- **Genes:** TMPRSS2 (transmembrane serine protease 2) [NCBI Gene 7113] {aka PRSS10}, ACE2 (angiotensin converting enzyme 2) [NCBI Gene 59272] {aka ACEH}, KITLG (KIT ligand) [NCBI Gene 4254] {aka DCUA, DFNA69, FPH2, FPHH, KL-1, Kitl}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, LYZ (lysozyme) [NCBI Gene 4069] {aka AMYLD5, LYZF1, LZM}, IL4R (interleukin 4 receptor) [NCBI Gene 3566] {aka CD124, IL-4RA, IL4RA}
- **Diseases:** bronchiolitis obliterans syndrome (MESH:D000092122), throat irritation (MESH:C538390), pulmonary infiltrates (MESH:D017254), pleural effusions (MESH:D010996), pneumonia (MESH:D011014), bacterial pneumonia (MESH:D018410), Airway diseases (MESH:D029424), bronchospasm (MESH:D001986), hematologic malignancies (MESH:D019337), ARDS (MESH:D012128), airway obstruction (MESH:D000402), Pulmonary cryptococcosis (MESH:D003453), Inflammation (MESH:D007249), Respiratory infections (MESH:D012141), dysphonia (MESH:D055154), injury to (MESH:D014947), pulmonary and systemic diseases (MESH:D012140), pulmonary aspergillosis (MESH:D055732), influenza (MESH:D007251), cancer (MESH:D009369), MAC lung disease (MESH:D008171), Lung cancer (MESH:D008175), RSV infection (MESH:D018357), asthma (MESH:D001249), CF (MESH:D003550), oropharyngeal candidiasis (MESH:D009959), CPA (MESH:D055744), Bacterial (MESH:D001424), ciliary dysfunction (MESH:D002925), Parasitic (MESH:D010272), tuberculosis (MESH:D014376), ILDs (MESH:D017563), Parasitic lung diseases (MESH:D008174), Fungal Infections (MESH:D009181), rhinosinusitis (MESH:D000092562), Infectious Diseases (MESH:D003141), pulmonary hypertension (MESH:D006976), chronic (MESH:D002908), Tissue Damage (MESH:D017695), community-acquired pneumonia (MESH:D003147), APSD (MESH:D020243), RA (MESH:D001172), fungal coinfections (MESH:D060085), Pseudomonas aeruginosa (MESH:D011552), FPF (MESH:D014202), bronchiectasis (MESH:D001987), Viral Infections (MESH:D014777), death (MESH:D003643), cystic lesions (MESH:D052177), COVID-19 (MESH:D000086382), infected (MESH:D007239), bacterial bronchitis (MESH:D001991), pulmonary tuberculosis (MESH:D014397), ABPA (MESH:D001229), toxicity (MESH:D064420), cough (MESH:D003371)
- **Chemicals:** adalimumab (MESH:D000068879), phospholipid (MESH:D010743), L-leucine (MESH:D007930), levofloxacin (MESH:D064704), posaconazole (MESH:C101425), Tobi Podhaler (MESH:D014031), glycine (MESH:D005998), voriconazole (MESH:D065819), glycolic acid (MESH:C031149), AZM (MESH:D017963), Oxygen (MESH:D010100), HFA (MESH:C094049), Chitosan (MESH:D048271), acid (MESH:D000143), nitrogen (MESH:D009584), polysaccharide (MESH:D011134), lactic acid (MESH:D019344), lactose (MESH:D007785), Remdesivir (MESH:C000606551), C (MESH:D002244), beta-lactam antibiotics (MESH:D008997), ciprofloxacin (MESH:D002939), sialic acid (MESH:D019158), Mannitol (MESH:D008353), lactide (MESH:C091880), itraconazole (MESH:D017964), CO2 (MESH:D002245), triazole (MESH:D014230), lipid (MESH:D008055), PLA (MESH:C033616), Dupilumab (MESH:C582203), heparin sodium (MESH:D006493), PLGA (MESH:D000077182), reactive oxygen species (MESH:D017382), Budesonide (MESH:D019819), trehalose (MESH:D014199), ALN-RSV01 (-), amino acids (MESH:D000596), ergosterol (MESH:D004875), isavuconazole (MESH:C508735), amphotericin B (MESH:D000666), polyesters (MESH:D011091), bicarbonate (MESH:D001639), arginine (MESH:D001120), phenylalanine (MESH:D010649), Amikacin (MESH:D000583)
- **Species:** Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Streptococcus pneumoniae (species) [taxon 1313], Fungi (kingdom) [taxon 4751], Penicillium (genus) [taxon 5073], Aspergillus fumigatus (species) [taxon 746128], Pseudomonas aeruginosa (species) [taxon 287], Saccharomyces cerevisiae (baker's yeast, species) [taxon 4932], Klebsiella pneumoniae (species) [taxon 573], Enterovirus (genus) [taxon 12059], Cryptococcus (genus) [taxon 79213], Scedosporium (genus) [taxon 41687], Influenza A virus (no rank) [taxon 11320], Respiratory syncytial virus (no rank) [taxon 12814], Orthomyxoviridae (family) [taxon 11308], Viruses (acellular root) [taxon 10239], H7N9 subtype (serotype) [taxon 333278], Homo sapiens (human, species) [taxon 9606], Candida [taxon 1535326], Mucorales (pin molds, order) [taxon 4827]

## Full text

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## Figures

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## References

326 references — full list in the complete paper: https://tomesphere.com/paper/PMC12944633/full.md

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Source: https://tomesphere.com/paper/PMC12944633