Abstract
It is estimated that most of the medicinal compounds developed during the 20th century have their origins in phenothiazines [1]. Among these medicinal compounds is the first neuroleptic chlorpromazine (CPZ) introduced in 1957. The wide use of CPZ resulted in many published observations that indicated activity against a wide variety of microorganisms that cause therapeutically problematic infections [2]. CPZ has been shown to have in vitro activity against antibiotic susceptible [3] and resistant strains of Mycobacterium tuberculosis [4], has cured the aortis monkey of an antibiotic resistant malaria infection [5] and has yielded a temporary cure of prion promoted CJD [6]. Because CPZ is a very noxious compound that produces frequent serious negative side effects, there has always been resistance to use of CPZ for therapy of non-psychotic pathologies. The replacement of CPZ by thioridazine (TZ), a phenothiazine that is far milder than CPZ and as effective as CPZ for therapy of pyschosis, promoted studies that investigated whether similar antimicrobial activities produced by CPZ are also produced by TZ. This commentary provides a brief review of the studies that indicated that TZ has the potential to cure multi-drug resistant and extensively drug resistant tuberculosis and a wide gamut of multi-drug resistant bacterial infections whose phenotype is mediated by overexpressed efflux pumps.
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