The University of Sydney, Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Sydney Medical School , NSW 2037, Sydney , Australia +61 2 91140352 ;
Expert Opin Drug Deliv. 2014 Mar;11(3):421-31. doi: 10.1517/17425247.2014.877886. Epub 2014 Jan 8.
Tuberculosis (TB) remains rampant throughout the world, in large part due to the lengthy treatment times of current therapeutic options. Rifapentine, a rifamycin antibiotic, is currently approved for intermittent dosing in the treatment of TB. Recent animal studies have shown that more frequent administration of rifapentine could shorten treatment times, for both latent and active TB infection. However, these results were not replicated in a subsequent human clinical trial.
This review analyses the evidence for more frequent administration of rifapentine and the reasons for the apparent lack of efficacy in shortening treatment times in human patients. Inhaled delivery is discussed as a potential option to achieve the therapeutic effect of rifapentine by overcoming the barriers associated with oral administration of this drug. Avenues for developing an inhalable form of rifapentine are also presented.
Rifapentine is a promising active pharmaceutical ingredient with potential to accelerate treatment of TB if delivered by inhaled administration. Progression of current fundamental work on inhaled anti-tubercular therapies to human clinical trials is essential for determining their role in future treatment regimens. While the ultimate goal for global TB control is a vaccine, a short and effective treatment option is equally crucial.
结核病（TB）在全球范围内仍然猖獗，这在很大程度上是由于目前治疗方案的治疗时间长。利福喷丁，一种利福霉素抗生素，目前已获准用于治疗结核病的间歇性给药。最近的动物研究表明，更频繁地给予利福喷丁可以缩短潜伏和活动性 TB 感染的治疗时间。然而，这些结果在随后的人类临床试验中并未得到复制。
本文分析了更频繁地给予利福喷丁的证据，以及这种药物在缩短人类患者治疗时间方面明显缺乏疗效的原因。还讨论了吸入给药作为一种潜在的选择，通过克服与这种药物口服给药相关的障碍来实现利福喷丁的治疗效果。还提出了开发利福喷丁吸入剂的途径。
利福喷丁是一种很有前途的活性药物成分，如果通过吸入给药，有可能加速结核病的治疗。将目前关于吸入式抗结核疗法的基础工作推进到人体临床试验对于确定它们在未来治疗方案中的作用至关重要。虽然全球结核病控制的最终目标是疫苗，但短期有效的治疗选择同样至关重要。
