Hopes of shorter duration treatment for tuberculosis (TB) are rising in the wake of preliminary findings from a clinical trial indicating that new combination therapy including the antibiotic Moxifloxacin can cut the time needed to cure drug-susceptible TB to 4 from 6 months.
The drug is now in the advanced stage of clinical trials and could conceivably be available by 2012 to aid nations struggling with a high incidence of TB, like India, which now contributes about one-third of the world's cases. The highly contagious bacterial disease annually kills over 2 million people worldwide.
The preliminary findings of a study of moxifloxacin as a new treatment for TB, presented at the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago last fall, indicated it is far more potent than standard therapy, which uses an older anti-TB drug, ethambutol. Substituting moxifloxacin for ethambutol in DOTS (directly directly observed therapy short course, the standard therapy for TB) could also make treatment far less costly, allowing TB programs to expand their coverage. It could be “a significant measure to improve TB treatment, provided the treatment is more effective, safe and relatively cheaper,” Bikram Saha, assistant professor of medicine at the Midnapore Medical College in West Bengal, told CMAJ.
“Tuberculosis is a big problem in developing countries, so we should welcome any innovative approach to control the disease. But it's essential that all the newer approaches should be thoroughly scanned through clinical studies.”
“This is the most compelling evidence in nearly 25 years that a novel antibiotic drug combination works better than the current gold standard at curing active TB infection,” said John Hopkins University School of Medicine Professor of Medicine, Epidemiology and International Health Richard E. Chaisson in a press release. “Beyond the obvious value of healing patients more quickly, a shorter treatment time could also cut down on transmission of the disease to others and make it easier for health care workers worldwide, who are overwhelmed by a large number of patients, to treat more people and to treat them faster.” – Sanjit Bagchi MBBS, Kolkata, India