OVERVIEW OF ANTI-TUBERCULOSIS (TB) DRUGS

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Anti-tuberculosis drugs are groups of antimicrobial agents that are used for the management and treatment of infections and/or disease caused by the Gram-negative, acid-fast and rod-like bacterium known as Mycobacterium tuberculosis. M. tuberculosis is the main causative agent of tuberculosis (TB); and this acid-fast bacillus is mainly reserved in humans. TB is a bacterial disease that is responsible for a handful of morbidity and mortality in human race, and the disease affects a large number of the world population both in the developed and developing world. However, most people with TB infection are not infectious because their immune system has the tubercle bacilli under control by producing macrophages that engulf the bacterium and prevents it from spreading. Only people with TB disease can transmit the infection through aerosols to susceptible and non-infected members of the community.

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In cases of TB infection, the M. tuberculosis is present in the individual but there are usually no signs and symptoms of the disease even though the patients test positive to the tuberculin (mantoux) skin text. And in such individuals, their x-ray results are normal and their sputum microscopy and culture comes back negative.

In cases of TB disease, chest x-ray results are positive, sputum microscopy and culture also comes back positive and the individual presents with the clinical symptoms of the disease including fever, productive cough and weight loss. Such individuals are often infectious, and can transmit the bacterium to uninfected members of the community; and their tuberculin skin test is also positive. In the treatment of TB, anti- tuberculosis drugs are usually administered in combinations and not singly because administering only one drug at a time will lead to the development of resistant strains of M. tuberculosis.

Nevertheless, prevention is usually better than cure when it comes to TB. And to this end, the BCG vaccine which consists of a live attenuated strain derived from Mycobacterium bovis is used in immunization to contain the development and spread of TB disease in the human race. BCG is the acronym for: Bacillus of Calmette and Guerin, which was named after the two Frenchmen that developed the vaccine. Isoniazid (INH), rifampin (RIF), pyrazinamide (PZA) and ethambutol (EMB) or streptomycin is the main antibacterial agents used for the clinical management of tuberculosis (TB).

FURTHER READING

Ashutosh Kar (2008). Pharmaceutical Microbiology, 1st edition. New Age International Publishers: New Delhi, India. 

Block S.S (2001). Disinfection, sterilization and preservation. 5th edition. Lippincott Williams & Wilkins, Philadelphia and London.

Courvalin P, Leclercq R and Rice L.B (2010). Antibiogram. ESKA Publishing, ASM Press, Canada.

Denyer S.P., Hodges N.A and Gorman S.P (2004). Hugo & Russell’s Pharmaceutical Microbiology. 7th ed. Blackwell Publishing Company, USA. Pp.152-172.

Ejikeugwu Chika, Iroha Ifeanyichukwu, Adikwu Michael and Esimone Charles (2013). Susceptibility and Detection of Extended Spectrum β-Lactamase Enzymes from Otitis Media Pathogens. American Journal of Infectious Diseases. 9(1):24-29.

Finch R.G, Greenwood D, Norrby R and Whitley R (2002). Antibiotic and chemotherapy, 8th edition. Churchill Livingstone, London and Edinburg.

Russell A.D and Chopra I (1996). Understanding antibacterial action and resistance. 2nd edition. Ellis Horwood Publishers, New York, USA.

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