Delamanid and its Role in Drug-Resistant Tuberculosis

Das, Supratik; Sehgal, Vijay Kumar

doi:10.18311/ijmds/2017/18807

Cited by 1 publication

(3 citation statements)

References 3 publications

(10 reference statements)

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“…The other adverse effects are nausea, vomiting, dizziness, low serum potassium levels, paraesthesia, anxiety and tremor. 19 In the clinical trials on the early bactericidal activity of delamanid, it was observed that there was increased reduction in CFU, observed with 200 mg/day and 300 mg/day doses. Delamanid showed monophasic bactericidal activity, in contrast to rifampicin and isoniazid, which showed biphasic activity.…”

Section: Discussionmentioning

confidence: 99%

“…18 Pre-clinical and clinical studies have shown that delamanid has high potency, least risk for drug-drug interactions and better tolerability, and post-antibiotic effect against intracellular bacilli, and these advantages of delamanid will be helpful in reducing the treatment time and risk of toxicity in MDR-TB. 19 A phase IIb randomised controlled trial in adults with pulmonary MDR-TB, showed improved rates of sputum culture conversion at 2 months when an OBR was augmented with delamanid, as compared to placebo. An open label extension of this trial found that patients who consumed delamanid for 2-6 months had more positive outcomes (cured or completed treatment) and lower mortality than those who took delamanid for ≤2 months.…”

Section: Discussionmentioning

confidence: 99%

“…Delamanid has an affordable cost and easy availability for the patients. 19 Patients likely to benefit from delamanid treatment are XDR-TB, pre-XDR-TB and MDR-TB patients. 18 With the advent of quinolones, and later the fluorinated 4quinolones, the fluoroquinolones, the medical world has certainly taken long strides in treating enormous number of maladies.…”

Section: Discussionmentioning

confidence: 99%

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A rational pharmacotherapeutic study of the prevalent prescription patterns of delamanid, ofloxacin, levofloxacin, and bedaquiline among the multi-drug resistant tuberculosis patients in global multi-centre tertiary care hospitals

Hazra

2021

Int J Basic Clin Pharmacol

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Background: Delamanid, a nitro-dihydro-imidazooxazole, is a bactericidal cell wall methoxy-mycolic and keto-mycolic acids biosynthesis inhibitor in actively replicating, dormant, and intracellular tuberculosis, and both drug-susceptible and drug-resistant strains of M. tuberculosis and M. kansasii, decreasing hydrophobicity and facilitating better bacterial drug penetration. Delamanid promotes intracellular generation of microbiocidal nitrogen oxidative intermediaries including nitric oxide, toxic even to dormant M. tuberculosis. Ofloxacin, the racemic mixture and levofloxacin, the S-or levorotatory isomer of ofloxacin, are bactericidal to M. tuberculosis, MAC, M. fortuitum, and other atypical mycobacteria, with inhibitory effect on DNA gyrase, DNA topoisomerase IV and IL-1α, IL-6, IL-8. Bedaquiline, a novel diarylquinoline, inhibits mycobacterial adenosine triphosphate synthase of M. tuberculosis, disrupting mycobacterial energy metabolism and replication. Bedaquiline’s initial bacteriostatic action is followed by a bactericidal effect after 5-7 days. The objective was to perform a rational pharmacotherapeutic study of the prevalent prescription patterns of delamanid, ofloxacin, levofloxacin, and bedaquiline, among the multi-drug resistant tuberculosis patients, in global multi-centre tertiary care hospitals.Methods: A multi-centre, retrospective, observational and analytical study of clinical prescriptions of 100 multi-drug resistant tuberculosis patients in hospitals, were performed. For 24-48 weeks, these patients had been prescribed anti-tubercular drugs, like delamanid 100 mg and ofloxacin 400 mg twice daily, levofloxacin 750 mg and bedaquiline 400 mg once daily followed by 200 mg thrice weekly, as part of MDR-TB treatment regimens. The no. of prescriptions for each drug were recorded, and the corresponding prescription rates were statistically derived in percentages. Results: Delamanid was most commonly prescribed (32 prescriptions, 32%), followed by ofloxacin (29 prescriptions, 29%), levofloxacin (24 prescriptions, 24%), and bedaquiline (15 prescriptions, 15%). The completeness of the prescription contents, the dose of drug, the duration of treatment, the instructions of medication, the frequency of drug intake, the name of the drug and the dosage form of the drug were observed in 100% of prescriptions.Conclusions: Prescription frequency of delamanid was followed by ofloxacin, levofloxacin and bedaquiline. Prescription content analyses showed 100% completeness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%