Antituberculosis therapy for 2012 and beyond

Abstract

Introduction In terms of human suffering, tuberculosis has a huge impact on global society, making it arguably the most important infectious disease in history. Despite the devastating impact on society, the tools to fight tuberculosis are very limited. Current standard therapy has been used for over 40 years and threats, such as the HIV epidemic and drug-resistant strains, undermine efforts to control the disease. New drugs are needed to address the challenges faced globally. Areas covered Current therapy is briefly reviewed in this paper and then new doses and combinations of existing drugs are presented. New candidate drugs are also discussed, along with the potential benefits and pitfalls of each of the compounds and approaches to therapy. Expert opinion Despite the need to develop new drugs, the ability of programs to deliver existing therapies must not be neglected. Directly observed therapy and a standard basic level of care for all patients with tuberculosis, regardless of where they reside, is imperative, and will ensure that new drugs and regimens will have the greatest possible impact. New combination regimens, including PA 824 and TMC207, in combination with existing drugs, are very exciting – not only because of their ability to shorten treatment regimens in pan-susceptible cases, but also because they can be used among drug-resistant strains. Although an effective vaccine will probably be necessary to eliminate tuberculosis, new drugs and combination regimens have the potential to save millions of lives before tuberculosis is finally eliminated.

The clinicpathologic features and MRI manifestations of the thoracic lumbar tuberculosis

“…World Health Organization of global tuberculosis report show that in recent years , tuberculosis infection recovered in the globe [4], with the growth of autoimmune diseases and the increase in drug-resistant bacteria, Tuberculosis bacteria like to grow in blood-rich places; and spine vertebral maybe one of the ideal places for mycobacterium tuberculosis to stay. Because spine vertebral is cancellous bone based, and with terminal arteries being its nutrient artery, venous blood flow slow here.…”

Pulmonary drug delivery systems for tuberculosis treatment

“…They include first-line anti-TB drugs like rifampicin, pyrazinamide and isoniazid, and second-line anti-TB drugs from the groups of aminoglycosides, capreomycin and para-amino salicylic acid. New chemical entities for TB treatment such as TMC207, PA-824, OPC-67683, PNU-100480, AZD-5847, SQ109 and BTZ043 were also considered for pulmonary application against TB (Grosset et al, 2012;Lauzardo and Peloquin, 2012). To benefit from lung delivery advantages as well as to overcome some challenges encountered in TB treatment, anti-TB drugs were developed with particulate drug delivery systems for pulmonary administration.…”

Targeting the mycobacterial envelope for tuberculosis drug development

“…Denny and colleagues explored different analogs of PA-824, in which the –OCH 2 linker is replaced by diverse ether linkers of varying size or flexibility, by testing derivatives containing amide, carbamate or urea functional groups [32,33]. PA-824 and OPC-67683 are in Phase II and Phase III clinical trials for MDR-TB treatments, respectively [34]. …”