Treatment of Tuberculosis. A Historical Perspective

Abstract

Of all achievements in medicine, the successful treatment of tuberculosis has had one of the greatest impacts on society. Tuberculosis was a leading cause of disease and a mortal enemy of humanity for millennia. The first step in finding a cure was the discovery of the cause of tuberculosis by Robert Koch in 1882. The sanatorium movement that began shortly afterward in Europe, and soon spread to the United States, brought attention to the plight of afflicted persons, and catalyzed public health action. The antituberculosis benefit of streptomycin was announced in 1945, although application was limited by the rapid development of resistance. para-Aminosalicylic acid, also discovered in 1945, when combined with streptomycin was found to greatly reduce the occurrence of drug resistance. In 1952, isoniazid opened the modern era of treatment; it was inexpensive, well tolerated, and safe. In the early 1960s, ethambutol was shown to be effective and better tolerated than para-aminosalicylic acid, which it replaced. In the 1970s, rifampin found its place as a keystone in the therapy of tuberculosis. The use of rifampin enabled the course of treatment to be reduced to nine months. Incorporation of pyrazinamide into the first-line regimen led to a further reduction of treatment duration to six months. Treatment of multiple drug-resistant tuberculosis remains a difficult problem requiring lengthy treatment with toxic drugs. However, shortened regimens show promise, and two new drugs, bedaquiline and delamanid, have demonstrated effectiveness in preliminary studies and are being used for extensively drug-resistant tuberculosis.

Pyrazinamide Is Active against Mycobacterium tuberculosis Cultures at Neutral pH and Low Temperature

“…P yrazinamide (PZA) is an important drug for TB treatment. PZA is used in standard first-and second-line therapies and is also included in many new regimens due to its unique ability to shorten therapy (1,2).…”

Tuberculosis resistance acquisition in space and time: an analysis of globally diverseM. tuberculosiswhole genome sequences

“…We compiled a 10,299 MTB WGS dataset with culture based DST (phenotypic) data using public 90 databases (Patric 14 , ReSeqTB 15 ) and literature curation [11][12][13][16][17][18][19][20][21][22][23][24][25][26] . A summary table with the 91 phenotypic data is available online at https://github.com/farhat-lab/resdata.…”

Population Pharmacokinetics of Rifampicin on Pulmonary Tuberculosis Patients

“…Nhu cầu đặt ra là tăng tối đa hiệu quả của việc điều trị bằng các thuốc hiện tại đang có, thay vì giải pháp tốn thời gian và chi phí hơn là phát triển thêm thuốc mới [4]; xây dựng mô hình dược động học quần thể là tiền đề cho việc nghiên cứu mô hình dược động học -dược lực học để tối ưu hóa liều điều trị. Rifampicin là một thuốc quan trọng trong phác đồ điều trị lao, có tác dụng tiêu diệt vi khuẩn, rút ngắn thời gian điều trị và tăng tỉ lệ điều trị thành công [5].…”