Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231-1002, USA.
Respirology. 2010 Jul;15(5):764-78. doi: 10.1111/j.1440-1843.2010.01775.x. Epub 2010 Jun 4.
Although treatment of drug-susceptible tuberculosis (TB) under ideal conditions may be successful in >or=95% of cases, cure rates in the field are often significantly lower due to the logistical challenges of administering and properly supervising the intake of combination chemotherapy for 6-9 months. Success rates are far worse for multidrug-resistant and extensively drug-resistant TB cases. There is general agreement that new anti-TB drugs are needed to shorten or otherwise simplify treatment for drug-susceptible and multidrug-resistant/extensively drug-resistant-TB, including TB associated with HIV infection. For the first time in over 40 years, a nascent pipeline of new anti-TB drug candidates has been assembled. Eleven candidates from seven classes are currently being evaluated in clinical trials. They include novel chemical entities belonging to entirely new classes of antibacterials, agents approved for use against infections other than TB, and an agent already approved for limited use against TB. In this article, we review the current state of TB treatment and its limitations and provide updates on the status of new drugs in clinical trials. In the conclusion, we briefly highlight ongoing efforts to discover new compounds and recent advances in alternative drug delivery systems.
尽管在理想条件下治疗药物敏感型结核病（TB）可能会在 >or=95%的病例中取得成功，但由于在 6-9 个月的时间内管理和适当监督联合化疗的摄入存在后勤挑战，实际情况下的治愈率通常要低得多。耐多药和广泛耐药性结核病病例的成功率要差得多。人们普遍认为，需要新的抗结核药物来缩短或简化药物敏感型和耐多药/广泛耐药性-TB 的治疗，包括与 HIV 感染相关的结核病。40 多年来，首次出现了新的抗结核药物候选物的萌芽管道。目前正在临床试验中评估来自七个类别的 11 种候选药物。它们包括属于全新抗菌药物类别的新型化学实体、批准用于治疗除结核病以外的感染的药物以及已批准用于有限治疗结核病的药物。在本文中，我们回顾了结核病治疗的现状及其局限性，并提供了临床试验中新药的最新情况。在结论中，我们简要介绍了正在进行的发现新化合物的努力以及替代药物输送系统的最新进展。
