Combating tuberculosis infection: A forbidding challenge

Abstract

After 50 years drought, several drugs are looming from the pipeline to combat tuberculosis. They will serve as a boon to the field that has been burdened with primitive, inadequate treatments and drug-resistant bacterial strains. From the decades, due to lack of interest and resources, the field has suffered a lot. Learning from the flaws, scientists have renovated their approaches to the finding of new antitubercular drugs. The first line drugs take about six months or more for the entire treatment. The second line remedy for resistant-tuberculosis requires daily injections which carry severe side effects. Drug resistance remains a constant menace because patients stop the medication once they start feeling better. So new drugs are required to be explored which are effective against tuberculosis especially drug resistant tuberculosis. These drugs need to work well with other drugs as well as with antivirals used for the treatment of human immunodeficiency virus. It is also very important to be considered that the treatments need to be cheap, as tuberculosis primarily affects people more in the developing countries. Further, new drugs must cure the disease in short span of time than the current six to nine month regimen. Recently a few new and potent drugs such as bedaquiline, delamanid, teixobactin have been evolved which may serve as a nice step forward, with a better outcome. Teixobactin, a new antibiotic has been found to have promising action against resistant strains, is also under consideration.

Inhalable Dry Powder of Bedaquiline for Pulmonary Tuberculosis: In Vitro Physicochemical Characterization, Antimicrobial Activity and Safety Studies

“…The epidemic situation of global TB has been aggravated by the rapid emergence of drug-resistant TB where the causative microorganism of TB, Mycobacterium tuberculosis, shows resistance to multiple first-line drugs (e.g., isoniazid and/or rifampicin) or sometimes those cases are untreatable by the available anti-TB drugs [2]. Development of new drugs could be an alternative option to improve the current situation of global TB [3].…”

A significant therapeutic effect of silymarin administered alone, or in combination with chemotherapy, in experimental pulmonary tuberculosis caused by drug-sensitive or drug-resistant strains: In vitro and in vivo studies

“…Our results suggest the possibility of using Sm as an adjuvant to antibiotic therapy, even against MDR-TB. The treatments need to be inexpensive, as TB primarily affects people from developing countries [2], and the treatments should be available for health systems to reach and treat more individuals [78]. Sm is in fact an inexpensive product that has been approved for human clinical trials.…”

“…Tuberculosis (TB) is an ancient infection caused by Mycobacterium tuberculosis . According to a WHO report, in the past year, 10.4 million people have developed active TB worldwide, and 1.4 million die each year [1, 2, 3]. TB is now the leading cause of death worldwide caused by an infectious agent—surpassing malaria and HIV [4].…”

<p>Recent advances in the treatment of pathogenic infections using antibiotics and nano-drug delivery vehicles</p>

“…Outside the liver and spleen, bacterial-infected macrophages are also found in the pulmonary cavities, eliminating these bacteria (active or dormant) remains one of the toughest challenges that developmental drug delivery systems currently face 112. For example, current treatment of pulmonary tuberculosis (TB) infection involves prolonged oral administration of high systemic doses of combined frontline antibiotics like rifampicin (RFP), isoniazid, pyrazinamide, and ethambutol over a 6- to 8-month period 113…”