Side Effects of TB Therapy and Recent Therapeutic Approaches for Tuberculosis Management

Abstract

Tuberculosis or TB caused by the micro-organism Mycobacterium tuberculosis is a highly contagious and the second most fatal disease after AIDS. It is estimated that it will soon surpass the deaths caused by HIV.BCG is the only vaccine available to prevent TB, however it is not effective in case of adult pulmonary TB which is actually the most common type of TB. The currently used treatment regimen in most developing countries is a single tablet with fixed dose combination of four drugs- Isoniazid (INH), Rifampicin, Ethambutol and Pyrazinamide which are 1st line anti-tubercular drugs. This combination reduces the risk of development of multi-drug resistant (MDR) Mycobacterium. But this drug combination is known to have various severe side-effects, which if not taken into consideration might lead to fatal reactions. MDR-TB treatment involves the use of 2nd line drugs which are less potent and more toxic compared to 1st line drugs. Increasing number of MDR strains of mycobacterium and failure of these conventional regimens to treat them is a huge challenge. Also, these side-effects associated with anti-TB drugs are a major reason for patient non-compliance and non-adherence to the treatment. Treatment discontinuation leads to increased risk of mortality and morbidity due to TB. Thus, it is very important to develop new therapeutic approaches towards the treatment of this disease which provide a better cure without relapse, lesser side-effects and prevents formation of drug resistant strains. The article reviews the various side-effects associated with the Anti-Tubercular drugs that are currently used and discusses certain newer, nanoparticle-basedapproaches to overcome the shortcomings of the current conventional therapy.