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Front-line medicines used in the treatment of tuberculosis

Abstract:

Tuberculosis has emerged as an enormous global public health epidemic. Worldwide, it is the second leading infectious cause of death, after HIV infection. The World Health Organization has estimated that every year, about 8 million persons develop active tuberculosis, and more than 2 million persons die from the disease. The goals of antituberculosis therapy are to ensure a cure without relapse, to prevent death, to stop transmission of M. tuberculosis, and to prevent the emergence of drug-resistant disease. Therapy is initiated with a multidrug regimen to kill tubercle bacilli rapidly, to minimize or prevent the development of drug-resistant M. tuberculosis strains, and to eliminate persistent organisms from host tissue to prevent relapse. Tuberculosis requires prolonged treatment. The minimum length of therapy for the treatment of drug-susceptible tuberculosis is 6 to 9 months with a rifampin-based regimen (so-called short-course therapy). Longer courses of therapy are required for drug-resistant tuberculosis, especially multidrug-resistant disease (i.e., disease caused by M. tuberculosis that is resistant to at least isoniazid and rifampin). Treatment of tuberculosis has two phases: initiation (also known as the bactericidal or intensive phase) and continuation (also known as the subsequent sterilizing phase). The aim of this article is to study the pharmacologic management of this entity focusing on standard antimicobacterial therapy. © 2007 Sociedad Venezolana de Farmacológia y Farmacológia Clínica y Terapéutica.