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New Tuberculosis Treatment Uses Old Antibiotics in Novel Ways

OCT 20, 2016 | EINAV KEET
“The advantage of cephalosporins over other beta-lactams, such as meropenem, is the ability to administer them orally instead of by parenteral route. However, caution should be exerted by health officials to recommend cephalosporins for TB treatment until properly designed clinical trials have validated their efficacy for TB therapy,” said Dr. Ramón-García.
 
New antibiotic development has declined markedly since the 1980s, and the authors of this study note that today it costs drug companies $2.6 billion to develop new drugs, urging health officials to do their best with what is already in our arsenal. “Drug development is a long and expensive process,” explained Dr. Ramón-García. “It takes an average of at least 15 years and millions of dollars to bring a single drug to the market. Drug repurposing is a strategy gathering momentum throughout the pharmaceutical industry, driven by the high costs of traditional drug development. Drug development for neglected diseases such as TB, mainly affecting developing countries, is especially complicated by the perception by big pharmaceutical companies that there is insufficient return on their capital investment.”
 
“In practice, this greatly limits the ability to perform costly clinical trials,” Dr. Ramón-García explained. “In addition, to get to the clinical stage, extensive lead optimization and pre-clinical studies need to be performed and funding is scarce. Because already approved drugs have previously passed all these phases and there is abundant information on safety and human efficacy, the time from bench discovery of in vitro activity to clinic can be greatly reduced. In addition, existing drugs can be used to treat patients that are in desperate need of new effective medications with minimal capital investment from pharma companies.”
 
The study authors note that by revisiting the use of cephalosporins against TB, they found that these antibiotics–which have gotten little consideration for TB treatment in the past–had good safety profiles and few drug-drug interactions. While they found first generation cephalosporins to be highly effective in their research, they found later generations of these drugs to be less effective. Cephalosporins showed the most promise among the beta-lactam antibiotics tested for synergistic activity with rifampicin.
 
Only individuals with active TB disease can spread it to others. While the TB vaccine is not commonly used in the United States, infants and children in areas at high risk for TB and healthcare workers treating TB-infected patients may be recommended for the vaccine.
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