Lay summary
Tuberculosis causes over ten million infections and over one million deaths each year. Treatment requires a long course of multiple antibiotics and is suboptimal: poor adherence, side effects, antibiotic resistance and treatment failure are common. Rifampicin, a first-line anti-TB medicine, is given orally for 6-24 months, and only a small fraction of the dose goes to the lungs (the commonest infection site). Direct delivery of rifampicin to the lungs by inhalation could achieve high drug levels in the lungs and blood to treat tuberculosis more effectively. Inhaled rifampicin combined with standard oral dose rifampicin could offer more effective and shorter treatment of tuberculosis, and could reduce side effects and treatment failure. In this project we will use nebulised rifampicin and conduct a clinical study in healthy human participants to confirm safety and determine the optimal dose. This will enable future clinical studies in patients with tuberculosis.