Formulations have been developed to treat or reduce the spread of respiratory infections, especially chronic or
drug resistant infections, particularly
tuberculosis (TB),
severe acute respiratory syndrome (SARS), meningococcal
meningitis, Respiratory syncytial
virus (RSV), influenza, and small pox. Formulations include a
drug or vaccine in the form of a
microparticle,
nanoparticle, or aggregate of nanoparticles, and, optionally, a carrier, which can be delivered by
inhalation. Giving the drugs via an
inhaler sidesteps the problems associated with oral or injectable drugs by bypassing the
stomach and liver, and delivering the medication directly into the lungs. In one embodiment, the particle containing the agent is a large porous
aerosol particle (LPPs). In another embodiment, the particles are nanoparticles, which can be administered as porous
nanoparticle aggregates with micron diameters that disperse into nanoparticles following administration. Optionally, the nanoparticles are coated, such as with a surfactant or
protein coating. The formulation may be administered as a
powder or administered as a solution or via an enteral or non-pulmonary
parenteral route of administration. The formulation is preferably administered as a pulmonary formulation. In the preferred embodiment for treatment of TB, the vaccine is a
BCG vaccine that is stable at
room temperature, or is an antibiotic effective against TB, such as capreomycin or PA-824, loaded at a very high percentage into the microparticles or nanoparticles. In one embodiment, a patient is treated with formulations delivering both antibiotic and vaccine.