Khoshnood Saeed, Taki Elahe, Sadeghifard Nourkhoda, Kaviar Vahab Hassan, Haddadi Mohammad Hossein, Farshadzadeh Zahra, Kouhsari Ebrahim, Goudarzi Mehdi, Heidary Mohsen
Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Front Microbiol. 2021 Oct 7;12:717045. doi: 10.3389/fmicb.2021.717045. eCollection 2021.
Multidrug-resistant (MDR) isolates of (MTB) remain a primary global threat to the end of tuberculosis (TB) era. Delamanid (DLM) is a nitro-dihydro-imidazooxazole derivative utilized to treat MDR-TB. DLM has distinct mechanism of action, inhibiting methoxy- and keto-mycolic acid (MA) synthesis through the F420 coenzyme mycobacteria system and generating nitrous oxide. While DLM resistance among MTB strains is uncommon, there are increasing reports in Asia and Europe, and such resistance will prolong the treatment courses of patients infected with MDR-TB. In this review, we address the antimycobacterial properties of DLM, report the global prevalence of DLM resistance, discuss the synergism of DLM with other anti-TB drugs, and evaluate the documented clinical trials to provide new insights into the clinical use of this antibiotic.
耐多药结核分枝杆菌（MTB）分离株仍然是终结结核病（TB）时代的主要全球威胁。德拉马尼（DLM）是一种用于治疗耐多药结核病的硝基二氢咪唑并恶唑衍生物。DLM具有独特的作用机制，通过F420辅酶分枝杆菌系统抑制甲氧基和酮基分枝菌酸（MA）的合成并产生一氧化二氮。虽然MTB菌株中对DLM耐药的情况并不常见，但在亚洲和欧洲有越来越多的报道，这种耐药性将延长耐多药结核病患者的治疗疗程。在本综述中，我们阐述了DLM的抗分枝杆菌特性，报告了DLM耐药的全球流行情况，讨论了DLM与其他抗结核药物的协同作用，并评估了已记录的临床试验，以提供关于这种抗生素临床应用的新见解。
