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Juraj Ivanyi, Alimuddin Zumla, Nonsteroidal Antiinflammatory Drugs for Adjunctive Tuberculosis Treatment, The Journal of Infectious Diseases, Volume 208, Issue 2, 15 July 2013, Pages 185–188, https://doi.org/10.1093/infdis/jit153
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(See the brief report by Vilaplana et al on pages 199–202.)
Tuberculosis continues to cause 1.4 million deaths annually despite effective treatment being available since the 1970s. The standard 4-drug tuberculosis treatment regimen involving isoniazid, rifampicin, pyrazinamide, and ethambutol achieves 90% cure rates in programmatic settings [1]. Mycobacterium tuberculosis bacilli are difficult to eradicate since they exist in a spectrum of replication states, from metabolically active, “rapid” replicators to nearly “dormant” nonreplicating persisters. Thus, treatment is required for a duration of at least 6 months in 2 phases: a 2-month intensive phase involving all 4 drugs and a 4-month continuation phase involving rifampicin and isoniazid. Major challenges for tuberculosis control programs include poor compliance, resulting in the emergence of multidrug-resistant M. tuberculosis strains, which require the use of more toxic second-line drugs for at least 24 months [1]; problems also arise from failures in drug supply and from drug intolerance. Shortening of the tuberculosis treatment period for both drug-susceptible and drug-resistant tuberculosis would greatly improve tuberculosis management and infection control.
