Effectiveness of Intravenous Isoniazid and Ethambutol Administration in Patients with Tuberculosis Meningoencephalitis and HIV Infection

Butov, Dmytro; Feshchenko, Y. I.; Kuzhko, Mykhailo; Gumenuik, Mykola; Yurko, Kateryna; Grygorova, Alina; Tkachenko, Anton; Nekrasova, Natalia; Tlustova, T.V.; Kikinchuk, V. V.; Peshenko, Alexandr; Butova, Tetyana

doi:10.4046/trd.2019.0021

Cited by 8 publications

(5 citation statements)

References 15 publications

(24 reference statements)

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“…44 Furthermore, a 2020 trial of replacing oral isoniazid and ethambutol with IV formulations resulted in significant clinical and radiographic improvement and higher rates of sputum conversion after 2 months of treatment in people with HIV with tuberculous meningitis compared with those treated with standard oral treatment. 45 However, these results have not been verified in larger populations.…”

Section: Treatmentmentioning

confidence: 85%

“…Therefore, a randomized controlled trial of high-dose oral and IV rifampicin is being launched to investigate whether this dosage achieves a higher CSF rifampicin concentration and improves outcomes 44 . Furthermore, a 2020 trial of replacing oral isoniazid and ethambutol with IV formulations resulted in significant clinical and radiographic improvement and higher rates of sputum conversion after 2 months of treatment in people with HIV with tuberculous meningitis compared with those treated with standard oral treatment 45 . However, these results have not been verified in larger populations.…”

Section: Tuberculous Meningitismentioning

confidence: 99%

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Neurologic Complications of Tuberculosis

Saylor¹

2021

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW: This article describes the current epidemiology, common clinical characteristics, and up-to-date evidence-based approaches to the diagnosis and management of the most common neurologic complications of tuberculosis (TB): tuberculous meningitis, intracranial tuberculoma, and spinal TB.RECENT FINDINGS: Central nervous system (CNS) TB remains common and associated with significant mortality and neurologic sequelae worldwide. Human immunodeficiency virus (HIV) co-infection is strongly associated with both the development of and mortality due to CNS TB. Strongyloides co-infection is associated with reduced CNS inflammation and improved outcomes in the setting of tuberculous meningitis. Stroke remains a common complication of tuberculous meningitis, and emerging evidence suggests aspirin may be used in this context. Although a recent nucleic acid amplification test has demonstrated suboptimal sensitivity in the diagnosis of CNS TB, emerging diagnostic techniques include cell-free DNA, peripheral blood microRNA, metagenomic next-generation sequencing, and advanced imaging techniques, but these are not yet well validated. CNS TB is associated with high mortality even with current treatment regimens, although novel, promising strategies for treatment are under investigation, including a combination of IV isoniazid and ethambutol and high-dose rifampicin.SUMMARY: TB can affect the nervous system in various ways and is associated with high mortality. Diagnosis remains challenging in endemic settings, with empiric treatment often initiated without a definitive diagnosis. Furthermore, optimal treatment regimens remain uncertain because current treatment for all forms of CNS TB is extrapolated from trials of tuberculous meningitis whereas the role of steroids in people with HIV and tuberculous meningitis remains controversial.

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Section: Treatmentmentioning

confidence: 85%

Section: Tuberculous Meningitismentioning

confidence: 99%

Neurologic Complications of Tuberculosis

Saylor¹

2021

CONTINUUM: Lifelong Learning in Neurology

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“…[2] Among the first-line treatment for combating TB include the use of combination of various drugs as shown in Figure 1, namely rifampicin (RFP), isoniazid (INH), pyrazinamide (PZA) and ethambutol (ETB) in certain dosage, as to effectively get rid of the bacteria while preventing antibiotic resistance to a particular drug. [3] However, the main emphasis of this research is specifically on INH and ETB, as they are commonly prescribed together for prolonged treatment of TB even in the initial phase. To simplify, INH helps to reduce the division of MTB in the body by inhibiting the synthesis of mycolic acid, while ETB works by hindering the production of an enzyme called arabinosyl transferase, where both components mentioned are essential elements required in the biosynthesis process of bacteria cell wall.…”

Section: Introductionmentioning

confidence: 99%

“…Among the first‐line treatment for combating TB include the use of combination of various drugs as shown in Figure 1, namely rifampicin (RFP), isoniazid (INH), pyrazinamide (PZA) and ethambutol (ETB) in certain dosage, as to effectively get rid of the bacteria while preventing antibiotic resistance to a particular drug [3] . However, the main emphasis of this research is specifically on INH and ETB, as they are commonly prescribed together for prolonged treatment of TB even in the initial phase.…”

Section: Introductionmentioning

confidence: 99%

Molecular Insight into the Ternary Complex Formation between Ethambutol, Isoniazid and β‐Cyclodextrin

Goh,

Adnan,

Jumbri

et al. 2024

ChemistrySelect

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Long term intake of antituberculosis drugs will lead to severe adverse reactions that will ultimately deteriorate a patient's health and well‐being. With that, the ternary inclusion complex was explored, whereby β‐cyclodextrin (β‐CD) was chosen as the supramolecular host carrier to accommodate two kinds of first line antituberculosis guest drug molecules simultaneously, namely isoniazid (INH) and ethambutol (ETB) which would provide many therapeutic benefits. The inclusion complex of β‐CD/INH/ETB was prepared using solvent evaporation method. Fourier transform infrared spectroscopy (FT‐IR), proton nuclear magnetic resonance spectroscopy (1H‐NMR), and 2‐dimensional nuclear Overhauser effect spectroscopy (2D‐NOESY) NMR were used to investigate the functional groups and structure of the complex. Scanning electron microscopy (SEM) and X‐ray diffraction (XRD) were employed to study the surface morphology and crystallinity changes during complex formation. Thermogravimetric analysis (TGA) was performed to investigate the thermal properties of the complex. FT‐IR and both types of NMR results had revealed the successful penetration of both the drug molecules into the β‐CD cavity. SEM images and XRD spectra had shown a drastic change in surface structure and reduction in crystallinity during complex formation, which had indicated successful formation of a new compound. TGA had proven that the complex had significantly greater thermal stability as compared to the pure components. Molecular dynamics (MD) and molecular docking simulations were also performed to understand the molecular interaction between β‐CD, INH, and ETB. Through precise calculations of interaction and binding energies, β‐CD/INH/ETB was found to be a more stable inclusion complex compared to the binary β‐CD/INH and β‐CD/ETB complexes.

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“…Todavia, apesar da efetividade dos fármacos por esta via, a literatura relata uma série de efeitos adversos (Singh, et al, 2019) causados em decorrência a exposição ao metabolismo de primeira passagem (Shetty, et al, 2019), exposição sistêmica e seus efeitos colaterais relacionados (Zhang, et al, 2011), além de haver perda na concentração do fármaco (Zhang, et al, 2018). Além da via oral, outra via de administração usada é a via parenteral, como a intravenosa (Butov, et al, 2020), contudo, segundo a literatura, também está associada a alta exposição sistêmica e suas complicações (Geraets, et al, 2014;Lankveld, et al, 2010). Research, Society and Development, v. 12, n. 1, e16912136950, 2023 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i1.36950 3 Neste sentido, a via inalatória destaca-se por se opor às desvantagens da via oral (Öztürk, et al, 2020), ao não ser invasiva (Anderson, et al, 2020), e, em particular, por aumentar a concentração do fármaco no órgão alvo de tratamento e, proporcionalmente, a biodisponibilidade do fármaco no pulmão (Li, et al, 2014), diminuindo sua exposição sistêmica (Lee, et al, 2015;Loira-Pastoriza, et al, 2014).…”

Section: Introductionunclassified

Liposomes techniques of aerosolization for the treatment of obstructive, restrictive and infectious pulmonary diseases: a review

Santos

Macêdo

Silva³

et al. 2023

RSD

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The current treatment of lung diseases, such as tuberculosis, chronic obstructive pulmonary disease (COPD), asthma, cancer and SARS-CoV-2, presents problems related to drug administration. Thus, nanotechnology, an innovative method that stands out in recent years, especially in nanomedicine, due to the development of materials on the nanometer scale (1-1000 nm). Among the various nanosystems, liposomes for their physicochemical properties, which make them a technology of interest to encapsulate hydrophilic or hydrophobic drugs, in addition to enabling controlled drug release. These techniques employed using an inhalation route have been considered as an alternative to deliver drugs encapsulated in site-specific liposomes. For this purpose, the literature describes several liposome aerosolization techniques in order to optimize an aerosolization system. The objective of this research was to carry out a bibliographic survey of the use of liposomes in the treatment of lung diseases as well as patents related to liposomes in aerosol dosage form. According to articles searched in Science Direct, Springer Nature, National Library of Medicine (PubMed) and Scientific Electronic Library Online (SCIELO) databases on the most used techniques such as Spray Drying, Spray Freeze Drying and Freeze Drying, specifically spray-drying is described in the literature as the solution base as the one that favors obtaining vesicles with low density, good fluidity and good dispersibility. In short, it was found that, linked to the use of spray-drying and nanotechnology, the inhalation route is a promising route for the administration of drugs aimed at the of lung diseases.

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Effectiveness of Intravenous Isoniazid and Ethambutol Administration in Patients with Tuberculosis Meningoencephalitis and HIV Infection

Cited by 8 publications

References 15 publications

Neurologic Complications of Tuberculosis

Neurologic Complications of Tuberculosis

Molecular Insight into the Ternary Complex Formation between Ethambutol, Isoniazid and β‐Cyclodextrin

Liposomes techniques of aerosolization for the treatment of obstructive, restrictive and infectious pulmonary diseases: a review

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