Antituberculosis Chemotherapy ( Progress in Respiratory Research )

Publication series : Progress in Respiratory Research

Author: Donald P.R.; van Helden P.D.  

Publisher: S. Karger AG‎

Publication year: 2011

E-ISBN: 9783805596282

P-ISBN(Paperback): 9783805596275

Subject: R978.3 anti - tuberculosis drugs, antileprosy drugs

Keyword: 传染病,流行病学与防疫,呼吸系及胸部疾病,药学,儿科学,基础医学,内科学,药物疗法、化学疗法

Language: ENG

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Description

Tuberculosis (TB) remains one of the major infectious diseases of mankind although drugs for its treatment have been available for nearly 60 years. The standard short-course 6-month regimen used since about 1980 has helped to save millions of lives, but co-infection with HIV has had a devastating effect on the epidemic, and multidrug-resistant TB is a growing problem, particularly in communities with a high incidence of HIV. Following the declaration by the WHO in the early 1990s that TB was a ‘global health emergency’, interest in TB research and the development of new drugs has increased significantly.This volume reviews anti-TB chemotherapy with the emphasis on the actions and pharmacology of existing drugs and the development and evaluation of new agents. A close look is taken at new research regarding our existing drugs by some of the best-known specialists in the field, and historical aspects of these agents are reviewed from a modern perspective. The prospects for the introduction of new drugs and different approaches of how to assess them in adults and in children are discussed in detail. Several papers address the problems associated with drug resistance, its spread and diagnosis.Compiled by two editors from Cape Town, which has a particularly high incidence of TB and is a centre of tuberculosis research, this publication is an indispensable reference for anyone involved in the management of TB either as a researcher, clinician or administrator, and those working in

Chapter

Implementation of the 18- Month Standard Treatment of Tuberculosis

Towards the 6- Month Short- Course Chemotherapy for Tuberculosis

References

Chapter 2: Tuberculosis Treatment Trials Past and Present: Old and New Challenges

Abstract

Introduction

Which Population Should We Be Using?

Selecting the Margin of Non- Inferiority

Reinfection

Trial Duration

End Points

The Primary End Point

Conclusion

References

Present Treatment

Chapter 3: The Rifamycins: Renewed Interest in an Old Drug Class

Abstract

Updated Review of the Pharmacokinetics of the Rifamycins

Pharmacodynamics of the Rifamycins

Updated Review of Drug Interactions with the Rifamycins

Implications for Clinical Trials and Clinical Practice

References

Chapter 4: Isoniazid Pharmacokinetics and Efficacy in Adults and Children

Abstract

Introduction

The Actions of Isoniazid and Isoniazid Resistance

The Pharmacokinetics and Pharmacodynamics of Isoniazid

The Dosage of Isoniazid in Children

Isoniazid Toxicity

Peripheral Neuropathy and Vitamin B6 (Pyridoxine) Supplementation

Acknowledgements

References

Chapter 5: Recent Developments in the Study of Pyrazinamide: An Update

Abstract

Mechanisms of Pyrazinamide Action

Pyrazinamide Activity in Persister Models

Conditions That Affect PZA Activity Other than Those That Slow Bacterial Metabolism

Target of Pyrazinamide

Pyrazinamide Resistance

Future Perspectives and Implications of Pyrazinamide for New Persister Drug Development

Acknowledgements

References

Chapter 6: Experience with Phase III Clinical Trials of Antituberculosis Drugs and Regimens: Conclusions and Lessons for the Future

Abstract

Previous Experience

Current Situation

Discussion

Conclusions

References

Chapter 7: Fluoroquinolones in the Management of Tuberculosis

Abstract

Development and Structure

Activity against Tuberculosis

Clinical Trials

Other Clinical Studies and Series

Resistance

Safety

Fluoroquinolones in Development for Tuberculosis

The Future of Fluoroquinolones

References

Chapter 8: Current Standard Treatment

Abstract

Establishment and Efficacy of Short- Course Chemotherapy, the Current Standard of Care

Intermittency: Efficient and Cost- Effective, or Not?

Supervision of Therapy: Does DOT Matter?

Conclusion

References

Chapter 9: Tuberculosis Recurrence: Exogenous or Endogenous?

Abstract

The Natural History of Mycobacterium tuberculosis Infection

Postprimary Tuberculosis: Endogenous Reactivation or Exogenous Reinfection

Recurrent Tuberculosis

Differentiation of M. tuberculosis Strains

Molecular Epidemiology: Challenging the Dogma

The Clinical Relevance of Exogenous Reinfection

Outstanding Knowledge

Conclusion

References

Chapter 10: Second- Line Antituberculosis Drugs: Current Knowledge, Recent Research Findings and Controversies

Abstract

The Injectable Antituberculosis Agents: Aminoglycosides and Cyclic Polypeptides

Ethionamide and Prothionamide (Thioamides)

Para-Aminosalicylic acid

Cycloserine and Terizidone

Clofazimine

β-Lactam Antibiotics in Combination with Clavulanate

Linezolid

Clarithromycin

Thiacetazone

References

Chapter 11: Acquisition, Transmission and Amplification of Drug- Resistant Tuberculosis

Abstract

Can Combination Therapy Prevent the Acquisition of Drug Resistance?

The Dogma that Tuberculosis Control Programmes Prevent Transmission of M. tuberculosis Strains

How Tuberculosis Control Programmes Promoted the Amplification of Resistance

Who Is to Blame?

Curbing the Multidrug-Resistant Tuberculosis Pandemic

References

Chapter 12: The Treatment of Tuberculosis in Children

Abstract

Microbiological Basis for Treatment

Current Treatment Regimens

Specific Scenarios

Following the Child Receiving Antituberculosis Chemotherapy

Future Directions

References

The Future

Chapter 13: Issues and Challenges in the Development of Novel Tuberculosis Drug Regimens

Abstract

Drugs in Clinical Development

Conclusion

References

Chapter 14: Drug Resistance in Mycobacterium tuberculosis: Molecular Mechanisms and Laboratory Susceptibility Testing

Abstract

Genetic Aspects of Drug Resistance

Principles of Drug Susceptibility Testing in the Laboratory

Isoniazid

Rifampicin

Ethambutol

Pyrazinamide

Fluoroquinolones

Ethionamide

Streptomycin, Amikacin, Kanamycin and Capreomycin

Streptomycin

Amikacin, Kanamycin and Capreomycin

Diagnostic Drug Susceptibility Testing

Clinical Implications of Drug Resistance

Quantitative Drug Susceptibility Testing

Acknowledgements

References

Chapter 15: The Role of the Mouse Model in the Evaluation of New Antituberculosis Drugs

Abstract

The Potential for More Rapid Assessment of Drug Efficacy in Mice

Measuring Sterilizing Activity

More Rapid Appraisal of Potential Sterilizing Activity

Modelling the Chemotherapy of Latent Tuberculosis Infection

Understanding the Pharmacodynamics of Antituberculosis Drugs

Utility of Other Animal Models

Conclusions

References

Chater 16: Current Issues in Tuberculosis Pharmacokinetics

Abstract

Practical Considerations

Therapeutic Drug Monitoring/Therapeutic Drug Management

Ethambutol

Isoniazid

Pyrazinamide

Rifampicin

Rifapentine

Human Immunodeficiency Virus and Rifamycins

The Fluoroquinolones

Conclusions

References

Chapter 17: Pharmacological Considerations of Antitubercular Agents in Children

Abstract

Isoniazid

Rifamycins

Pyrazinamide

Ethambutol

Aminoglycosides

Fluoroquinolones

Para-Aminosalicylic Acid

Cycloserine (Seromycin) and Terizidone

Thioamides

Clofazimine (Lamprene, B663)

Linezolid

Thiacetazone (Amithiozone, Thioacetazone)

The Diarylquinoline TMC207 (R207910)

Considerations for Paediatric Drug Development and Prospective Study Design

Conclusions

References

Chapter 18: Pharmacogenetics of Antituberculosis Drugs

Abstract

Basic Concepts in Pharmacogenetics

Mechanisms for Genetic Variation to Affect Drug Response

Pharmacogenetics of Antituberculosis Drugs: Isoniazid

Other First-Line Antituberculosis Drugs

Second-Line Anti-TB Drugs

New Anti-TB Drugs in Development

Application of Pharmacogenetics in Clinical Practice and Barriers to Its Application

Conclusions and Future Perspectives

References

Chapter 19: Interactions between Antituberculosis and Antiretroviral Agents

Abstract

Pharmacokinetic Interactions

Antituberculosis Drug Concentrations in Patients Infected with the Human Immunodeficiency Virus

Pharmacokinetics in Children

Toxicity

First-Line Antiretroviral Therapy Regimens

Second-Line Antiretroviral Therapy Regimens

Alternative Regimens

Regimens for Children

Conclusions

Acknowledgements

References

Chapter 20: Diabetes Mellitus and Tuberculosis Treatment

Abstract

Diabetes Mellitus and Tuberculosis – Epidemiology

Diabetes Mellitus and Tuberculosis – Clinical Presentation

Combined Treatment of Diabetes Mellitus and Tuberculosis

Pharmacokinetics of Tuberculosis Drugs in Patients with Diabetes Mellitus

Tuberculosis Screening and Prophylactic Treatment for Diabetes Patients

Conclusions

References

Chaper 21: Early Bactericidal Activity of Antituberculosis Agents

Abstract

Pharmacokinetics and Pharmacodynamics

New Classes of Antituberculosis Agents

Alternative Methodologies to Evaluate Bactericidal Activity

Conclusion

References

Chapter 22: Assessment of Whole- Blood Bactericidal Activity in the Evaluation of New Antituberculosis Drugs

Abstract

Rationale

Technical Aspects

Data Analysis

Studies in Tuberculosis Patients

Studies in Healthy Volunteers

Questions for Future Research

References

Chapter 23: Serial Sputum Colony Counting in Drug Development

Abstract

Bacteriological Biomarkers as Surrogates of Sterilizing Activity

Evolution of Quantitative Bacteriology

Recent Experience with Serial Sputum Colony Counting

The Nairobi Serial Sputum Colony Counting Study: Short Course and Standard Regimens

The Durban Serial Sputum Colony Counting Cohort: Fluoroquinolones in Drug- Susceptible Disease

The Bangkok Serial Sputum Colony Counting Cohort: Pharmacokinetic- Pharmacodynamic Analysis of First-Line Therapy

Serial Sputum Colony Counting in the Assessment of TMC207 in Multidrug- Resistant Disease

Current Limitations

Future Applications

References

Chapter 24: The Evaluation of New Antituberculosis Drugs in Children

Abstract

Burden of Childhood Tuberculosis

Treating Children with Tuberculosis

The Need for Access to New Drugs

The Regulatory Environment of Paediatric Drug Development

When to Initiate Paediatric Development

Children Are Not Small Adults

Development of Child-Friendly Drug Formulations

Tuberculosis Drug Development Guidance

Conclusion

Disclosure Statement

References

Chapter 25: A New Era in Tuberculosis Treatment: What Does the Future Hold?

Abstract

Barriers to Treatment Shortening

The Present

The Future

References

Author Index

Subject Index

Cover

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