Drug resistant Tuberculosis: A review

Khawbung, Jessy Lallungawi; Nath, Durbba; Chakraborty, Supriyo

doi:10.1016/j.cimid.2020.101574

Cited by 128 publications

(112 citation statements)

References 114 publications

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“…TB is a fatal, airborne, chronic, infectious disease caused by M. tuberculosis complex, a generic term that includes all the mammalian tubercle bacilli consisting of very similar Mycobacterium species [19]. Of these, only M. tuberculosis causes human TB, along with M. canetti.…”

Section: Pathogenesismentioning

confidence: 99%

Application of Lipid-Based Nanocarriers for Antitubercular Drug Delivery: A Review

et al. 2021

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The antimicrobial drugs currently used for the management of tuberculosis (TB) exhibit poor bioavailability that necessitates prolonged treatment regimens and high dosing frequency to achieve optimal therapeutic outcomes. In addition, these agents cause severe adverse effects, as well as having detrimental interactions with other drugs used in the treatment of comorbid conditions such as HIV/AIDS. The challenges associated with the current TB regimens contribute to low levels of patient adherence and, consequently, the development of multidrug-resistant TB strains. This has led to the urgent need to develop newer drug delivery systems to improve the treatment of TB. Targeted drug delivery systems provide higher drug concentrations at the infection site, thus leading to reduced incidences of adverse effects. Lipid-based nanocarriers have proven to be effective in improving the solubility and bioavailability of antimicrobials whilst decreasing the incidence of adverse effects through targeted delivery. The potential application of lipid-based carriers such as liposomes, niosomes, solid lipid nanoparticles, nanostructured lipid carriers, nano and microemulsions, and self-emulsifying drug delivery systems for the treatment of TB is reviewed herein. The composition of the investigated lipid-based carriers, their characteristics, and their influence on bioavailability, toxicity, and sustained drug delivery are also discussed. Overall, lipid-based systems have shown great promise in anti-TB drug delivery applications. The summary of the reviewed data encourages future efforts to boost the translational development of lipid-based nanocarriers to improve TB therapy.

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Section: Pathogenesismentioning

confidence: 99%

Application of Lipid-Based Nanocarriers for Antitubercular Drug Delivery: A Review

et al. 2021

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“…MDR-TB occurrence causes more significant impact on controlling the transmission since isoniazid and rifampicin played an essential role in the TB management approach. The treatment options available for MDR-TB are expensive and require at least 18 months of therapy [ 29 ]. In 2016, the WHO established a guideline to a shorten the MDR-TB treatment regimen of about 9–12 months as the first option in patients with MDR-TB or rifampicin-resistant TB (RR-TB) that are not resistant to fluoroquinolones or second-line injectable agents.…”

Section: Current Antituberculosis Drugsmentioning

confidence: 99%

Antituberculosis Targeted Drug Delivery as a Potential Future Treatment Approach

et al. 2021

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Mycobacterium tuberculosis (Mtb) is the microorganism that causes tuberculosis. This infectious disease has been around for centuries, with the earliest record of Mtb around three million years ago. The discovery of the antituberculosis agents in the 20th century has managed to improve the recovery rate and reduce the death rate tremendously. However, the conventional antituberculosis therapy is complicated by the development of resistant strains and adverse drug reactions experienced by the patients. Research has been conducted continuously to discover new, safe, and effective antituberculosis drugs. In the last 50 years, only two molecules were approved despite laborious work and costly research. The repurposing of drugs is also being done with few drugs; antibiotics, particularly, were found to have antituberculosis activity. Besides the discovery work, enhancing the delivery of currently available antituberculosis drugs is also being researched. Targeted drug delivery may be a potentially useful approach to be developed into clinically accepted treatment modalities. Active targeting utilizes a specifically designed targeting agent to deliver a chemically conjugated drug(s) towards Mtb. Passive targeting is very widely explored, with the development of multiple types of nanoparticles from organic and inorganic materials. The nanoparticles will be engulfed by macrophages and this will eliminate the Mtb that is present in the macrophages, or the encapsulated drug may be released at the sites of infections that may be in the form of intra- and extrapulmonary tuberculosis. This article provided an overview on the history of tuberculosis and the currently available treatment options, followed by discussions on the discovery of new antituberculosis drugs and active and passive targeting approaches against Mycobacterium tuberculosis.

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“…Although TB can be successfully cured in the vast majority of patients, some individuals develop resistance to first-line anti-TB therapy, comprising isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin [ 4 ]. Polydrug-resistant TB (PDR-TB) occurs when a patient develops resistance to two or more first-line anti-TB agents other than isoniazid and rifampicin [ 5 ]. On the other hand, multidrug-resistant TB (MDR-TB) occurs when a patient develops resistance to both isoniazid and rifampicin with or without other first-line agents [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Drug Resistance to Anti-Tuberculosis Drugs: A Cross-Sectional Study From Makkah, Saudi Arabia

Al-Hayani¹,

Kamel²,

Almudarra³

et al. 2021

Cureus

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Aim The aim of this study was to investigate the patterns and determinants of drug resistance to tuberculosis (TB) in a large population from Makkah, Saudi Arabia. Methods A retrospective, cross-sectional cohort study was conducted on all patients with TB who were referred to the National Tuberculosis Prevention Program in Makkah, Saudi Arabia, between January 2016 and September 2020. For each TB case, demographic data were collected in addition to the results of drug susceptibility testing (DST) for anti-TB drugs. The Statistical Package for Social Sciences (SPSS) software for Windows, version 23 (IBM Corporation, Armonk, NY, USA), was used for the statistical analysis. Results A total of 472 TB-confirmed cases were included in the analysis. The mean ± standard deviation of the age was 38.5 ± 17.7 years. The vast majority of patients were male (62.7%) and had pulmonary TB (91.7%). Only a small proportion of the patients with TB had diabetes mellitus (8.5%). Overall, the prevalence of monodrug-resistant TB ranged from 2.1% to 3.4%. Specifically, the prevalence of monodrug-resistant TB to isoniazid and streptomycin was ranked first and was equal to 3.4%. Pyrazinamide had the lowest prevalence of monodrug-resistant TB (2.1%). The prevalence of polydrug-resistant TB (PDR-TB) and multidrug-resistant TB (MDR-TB) was 1.5%. In the univariate analysis, sex (male) was the only sociodemographic factor that significantly correlated with a higher prevalence of MDR-TB. Conclusions This is the second study from Makkah to analyze the prevalence and associated risk factors of MDR-TB among patients from Makkah. Our data demonstrated that the prevalence of monodrug-resistant TB and MDR-TB was low (2.1%-3.4% and 1.5%, respectively). Diabetes mellitus was not a substantial factor correlated with a higher occurrence of MDR-TB. Additional epidemiologic studies are required to validate our results.

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Drug resistant Tuberculosis: A review

Cited by 128 publications

References 114 publications

Application of Lipid-Based Nanocarriers for Antitubercular Drug Delivery: A Review

Application of Lipid-Based Nanocarriers for Antitubercular Drug Delivery: A Review

Antituberculosis Targeted Drug Delivery as a Potential Future Treatment Approach

Drug Resistance to Anti-Tuberculosis Drugs: A Cross-Sectional Study From Makkah, Saudi Arabia

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