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Abstract
Available data on anti-tuberculosis drug research reveal different properties of the agents and provoke speculation about future directions. Higher doses of the rifamycins are promising and are currently being evaluated in regimens of shorter duration that the isoniazid plus rifampin-based, six-to-nine month-course therapy. Moxifloxacin and gatifloxacin might shorten tuberculosis treatment as well, possibly in combination with rifapentine, while SQ109 could enhance the activity of rifampin-containing regimens. On the other hand, co-administration of moxifloxacin and PA-824 could be active against latent tuberculosis, whereas linezolid, PA-824 and TMC207 are candidates for a rifampin-free regimen in multidrug-resistant and extensively-resistant tuberculosis. Unfortunately, shorter than existent treatment regimens based on the new agents discussed here are likely to take at least another decade to be fully developed and implemented in clinical practice.
Keywords:
High dose of rifamycins
New drug combinations
Resumen
Los datos disponibles en el proceso de investigación de nuevos fármacos antituberculosos han descubierto diferentes propiedades de los compuestos que permiten crear expectativas acerca de sus futuras indicaciones. Modelos terapéuticos que incluyan altas dosis de rifamicinas y pautas que asocien rifapentina con moxifloxacino o gatifloxacino podrían acortar el tratamiento de la tuberculosis, mientras que SQ109 incrementaría la actividad de las combinaciones basadas en esta rifamicina. Por otra parte, la tuberculosis latente podría tratarse adecuadamente con la asociación de moxifloxacino y PA-824, y la tuberculosis multirresistente y extensamente resistente con linezolid, PA-824 y TMC207, en pautas sin rifampicina. Desgraciadamente, tratamientos más cortos que los existentes, basados en asociaciones de los fármacos que se comentan en este trabajo, llevarán al menos otra década para ser completamente desarrollados e introducidos en la práctica clínica.
Palabras clave:
Altas dosis de rifamicinas
Nuevas combinaciones de fármacos
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