Anti-Tuberculosis Drug Rifampicin Can Be Safely Dosed Even Higher, New Study Shows; May Lead to Shorter Treatment Time and Reduced Antibiotic Resistance

A considerably higher dose of the anti-tuberculosis drug rifampicin is safe and can also lead to a shorter treatment for tuberculosis (TB) and less resistance. This is what researchers from Radboud University Medical Center in Nijmegen, the Netherlands, write in a February 4, 2021 publication European Respiratory Journal. The article is titled“Increased bactericidal activity but dose-limiting intolerability at 50 mg·kg−1 rifampicin” https://erj.ersjournals.com/content/early/2020/12/10/13993003.00955-2020. With this study, the researchers complete a year-long search for the right dosing of an old drug against tuberculosis that appears to be the key drug. Tuberculosis is a deadly, pertinacious bacterial infectious disease that affects nine million people worldwide each year, mainly in countries in low- and middle-income countries. For over a million of these people, the disease has a fatal outcome. Although drug manufacturers have been developing tuberculosis drugs for forty years, supplemented by research on the BCG vaccine, which appears to strengthen the immune system against respiratory infections, the number of people affected by tuberculosis remains fairly stable. This is partly due to patients being treated for too short a time or with inadequate medication. Due to TB treatment being inadequately dosed or for too short a time, many drugs do not touch, or barely reach, all TB bacilli in the body. This can lead to resistance: the pathogens that survive the treatment multiply, after which the disease returns in a new form that is even more difficult to treat. Effective treatments for drug-resistant tuberculosis are therefore tough and last a long time, sometimes up to eighteen months.
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