Tuberculosis - Present Medication and Therapeutic Prospects

Abstract

Background: Tuberculosis (TB) has been present in the history of human civilization since time immemorial and has caused more deaths than any other infectious disease. It is still considered one of the ten most common epidemiologic causes of death in the world. As a transmissible disease, it is initiated by rod-shaped (bacillus) mycobacteria. The management of tuberculosis became possible owing to several discoveries beginning in 1882 with the isolation of the TB bacillus by Robert Koch. The diagnosis of TB was enabled by finding a staining method for TB bacteria identification (1883). It was soon realized that a large-scale policy for the treatment and prevention of tuberculosis was necessary, which resulted in the foundation of International Union against Tuberculosis and Lung Diseases (1902). An antituberculosis vaccine was developed in 1921 and has been in therapeutic use since then. TB treatment regimens have changed over the decades and the latest recommendations are known as Directly Observed Treatment Short-course (DOTS, WHO 1993). Methods: A search of bibliographic databases was performed for peer-reviewed research literature. A focused review question and inclusion criteria were applied. Standard tools were used to assess the quality of retrieved papers. Results: A total of 112 papers were included comprising original publications and reviews. The paper overviews anti-TB drugs according to their mechanism of action. The chemical structure, metabolism and unwanted effects of such drugs have been discussed. The most recent treatment regimens and new drugs, including those in clinical trials, are also presented. Conclusion: Despite a 22% decrease in the tuberculosis fatality rate observed between 2000 and 2015, the disease remains one of the ten prime causes of death worldwide. Increasing bacterial resistance and expensive, prolonged therapies are the main reasons for efforts to find effective drugs or antituberculosis regimens, especially to cure multidrug-resistant tuberculosis.

Validation of Differentially Expressed Immune Biomarkers in Latent and Active Tuberculosis by Real-Time PCR

“…For India in the same period the estimated incidence of TB was approximately 2.8 million people per year, accounting for about a quarter of the world's TB cases (8)(9)(10) and resulting in considerable mortality (11). Optimal patient care requires early detection, intervention with antibiotic therapy and judicious ongoing management of infectious individuals (8,(12)(13)(14). If untreated, each person with pulmonary ATB will infect others at a high rate, on average between 5 and 15 close contacts every year (15).…”

“…If caught early enough treatment can be implemented which is less rigorous and results in less severe disease/long term organ damage and fewer relapses ( 16 , 22 , 40 ). Isoniazid monotherapy for 6 months is the primary recommended treatment for LTBI in both adults and children in countries with high and low TB incidence, in contrast to the more intensive combined treatment/DOTS for ATB ( 13 ). Non-compliance with anti-mycobacterial therapies contribute to difficulties in disease eradication ( 25 , 45 , 46 ).…”

Immunochromatographic Detection of MPB64 Secreted from Active BCG by Heating: Toward Same-Day Diagnosis of Tuberculosis

“…tuberculosis, is one of the top ten causes of death worldwide [1]. The WHO reported that in 2017, 10 million people contracted TB and 1.6 million people died from the disease (including 0.3 million people with HIV) [2].…”