New Perspectives in Drug Delivery Systems for the Treatment of Tuberculosis

Abstract

Background: Tuberculosis is a chronic respiratory disease caused by Mycobacterium tuberculosis. The common treatment regimens of tuberculosis are lengthy with adverse side effects, low patient compliance, and antimicrobial resistance. Drug delivery systems (DDSs) can overcome these limitations. Objective: This review aims to summarize the latest DDSs for the treatment of tuberculosis. In the first section, the main pharmacokinetic and pharmacodynamic challenges posed by the innate properties of the drugs are put forth. The second section elaborates on the use of DDS to overcome the disadvantages of the current treatment of tuberculosis. Conclusion: We reviewed research articles published in the last 10 years. DDSs can improve the physicochemical properties of anti-tuberculosis drugs, improving solubility, stability, and bioavailability, with better control of drug release and can target alveolar macrophages. However, more pre-clinical studies and robust bio-relevant analyses are needed for DDSs to become a feasible option to treat patients and attract investors.

Long-Term Intake of Linezolid Elevates Drug Exposure and Reduces Drug Clearance and Elimination in Adults With Drug-Resistant Pulmonary Tuberculosis

“…Several factors (host and physiochemical properties of a drug molecule) are known to influence the metabolism of a drug and thus affect its pharmacokinetic property. [18][19][20] Among host factors, impaired renal function has been shown to be associated with LZD clearance, leading to elevated trough concentration and drug exposure, particularly in sepsis and critically ill patients. [21][22][23] However, studies associated with some of the key indicators of renal function, including creatinine clearance, glomerular filtration rate, and the pharmacokinetic characteristics of LZD in DR-TB are scarce.…”

CLPC1 protein inhibition, antimycobacterial, and anti‐inflammatory properties of the metabolite from Streptomyces wuyuanensis collected in Nghe An province, Vietnam

“…have been extensively used to treat TB disease. 6 Nevertheless, the number of TB drugresistances is still growing fast, requiring the exploration for new TB drugs that are non-toxic, less side effects, and completely kill M. tuberculosis.…”

“…The 1st, 2nd, and 3rd generation antibiotic such as rifampicin, isoniazid, pyrazinamide, clofazimine, rifapentine, etc. have been extensively used to treat TB disease 6 . Nevertheless, the number of TB drug‐resistances is still growing fast, requiring the exploration for new TB drugs that are non‐toxic, less side effects, and completely kill M. tuberculosis .…”

Comprehensive Therapeutic Approaches to Tuberculous Meningitis: Pharmacokinetics, Combined Dosing, and Advanced Intrathecal Therapies

“…Determining the optimal combinations, durations, doses, and frequencies of drug regimens for TBM remains uncertain, with insufficient evidence to guide empiric treatment regimens for TBM [ 11 ]. The blood–brain barrier (BBB) complicates matters by impeding drug delivery to the CNS, necessitating alternative administration methods to ensure optimal drug concentration in the cerebrospinal fluid (CSF) and brain [ 17 ].…”