Short-course Treatment Research Articles

Understanding the key challenges in tuberculosis drug discovery: what does the future hold?

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health concern. It spreads through airborne droplets and has a high mortality rate, particularly without treatment. Drug resistance is rising, with treatments against multidrug-resistant TB (MDR-TB) showing poor treatment success rates. The thick, lipid-rich wall of Mtb and its slow growth reduce antibiotic effectiveness, requiring long treatment courses of 4-6 months. Current therapies often fail against drug-resistant strains, highlighting the urgent need for new, short-course treatment, affordable, and combination-friendly drugs. Within this perspective, the authors review and comment on the following topics regarding Mtb resistance emergence and treatment strategies: i) Existing treatment ii) Resistance evolution in Mtb; iii) Key challenges in drug discovery targeting Mtb; iv) emerging strategies and recent advances in Mtb drug discovery, and v) Next-generation approaches. Literature was identified through a search of PubMed, google scholar, and web of science, from January 2010 to March 2025. AI is accelerating the discovery of bioavailable and safe preclinical drug candidates for TB, though data limitations and biological complexity remain challenging. Future progress requires multi-modal models, open-access datasets, and interdisciplinary collaboration.

Explicit Sensory Retraining in Physiotherapy to Treat People with Chemotherapy-Induced Peripheral Neuropathy (CIPN): A Feasibility Study

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a nerve damage condition caused by anti-neoplastic drugs, resulting in pain and sensory impairment in extremities, affecting balance and mobility. This study assessed the feasibility and effectiveness of a short sensory retraining physiotherapy treatment course for CIPN symptoms. Methods: A prospective feasibility trial (NCT05382520) was conducted in an outpatient cancer clinic. Twelve participants with chronic CIPN underwent three 45-minute sessions of explicit sensory retraining of the lower extremities. Primary outcome measures included the Visual Analogue Scale (VAS), Treatment Induced Neuropathy Assessment Scale (TNAS), and “Timed Up & Go” test (TUG). In addition, sensory function and balance as well as participant satisfaction were also evaluated. Statistical analysis used the Wilcoxon rank test with significance set at P ≤ 0.05. Results: All participants completed the intervention. Significant improvements were found in median “maximal pain intensity” (VAS-weekly max; P = 0.02) and median “average pain” (VAS-weekly average; P = 0.01). TUG median decreased significantly by 4.7 seconds (P = 0.01). TNAS scores decreased by 13.0 (P = 0.06). Several secondary outcome measures also showed significant improvements. Participant satisfaction was 82.4%. Conclusions: Explicit sensory retraining for lower extremities in individuals with CIPN is feasible and was found to be effective in both improving pain and mobility, with high participant satisfaction. This study suggests a new, mechanism-based therapeutic approach to ease CIPN symptoms, to be further investigated in prospective randomized trials.

Successful experience of secukinumab therapy in a patient with severe chronic suppurative hidradenitis.

Severe forms of hidradenitis suppurativa are characterized by a chronic recurrent course, accompanied by active inflammation, the formation of nodes and abscesses, fistulas with abundant purulent discharge, cicatricial changes. A clinical case of a patient who had not been diagnosed with chronic hidradenitis suppurativa for a long time is described. The following diagnoses were erroneously made: "Inverse acne", "Chronic furunculosis", "Chronic pyoderma. Secondary immunodeficiency" and the patient received ineffective therapy with short courses of various antibacterial drugs, isotretinoin, systemic glucocorticosteroids, and surgical treatment. The absence of a correct diagnosis, incorrect tactics in management, and the ineffectiveness of the therapy carried out over several years led to the spread of the process, impaired ability to work, and disability of the patient. The diagnosis of chronic suppurative hidradenitis and the prescription of secukinumab resulted in a positive outcome. Treatment with secukinumab for 12 months provided a stable remission in the patient. A clinical case of secukinumab use in a patient with severe suppurative hidradenitis showed that treatment with this drug can be effective and well tolerated.

Clinical Efficacy of Modified and Conventional Aspiration for Breast Abscess: A Comparative Analysis.

Clinical Efficacy of Modified and Conventional Aspiration for Breast Abscess: A Comparative Analysis.

Adaptive Radiation Therapy in Lymphomas: Indications, Early Experiences, and Future Directions.

Adaptive Radiation Therapy in Lymphomas: Indications, Early Experiences, and Future Directions.

Comparison of Clinical Outcomes of Short-Course vs Long-Course Antibiotic Treatment in Children With Pyelonephritis

To evaluate the comparative effectiveness of short-course vs long-course antibiotic treatment for clinical outcomes of children with pyelonephritis. Methodology: A retrospective observational study was conducted in the Pediatrics Department of PIMS Hospital, Islamabad, between May 2024 and May 2025. A total of 200 children aged from 6 months to 18 years presenting in the outpatient department with urine culture showing the presence of Escherichia coli, Klebsiella species, or Proteus mirabilis were selected for the study. Children were divided into two treatment groups by physicians; Group A included 100 patients who were administered the short-course antibiotic treatment for 6-9 days, and Group B included 100 patients treated for 10 or more days. The primary endpoint was treatment failure, shown by the occurrence of one or more composite outcomes in 1 month following treatment. Results: The odds ratio of achieving the composite outcomes at follow-up between both groups was 1.19 (95% CI: 0.81-2.02). There was no significant difference between outcomes concerning age between both groups however between the age groups, children aged 4-13 years had a significantly higher frequency of treatment failure (14.7%) as compared to other age groups (9 vs 8.2%) irrespective of treatment (OR: 1.68, 95% CI: 1.12-2.81, p<0.01). 40% patients in Group A and 65% in Group B had a recurrence with an increasingly resistant organism at follow-up (OR: 0.40, 95% CI: 0.11-1.48). Conclusion: The effect of short-course and long-course antibiotic treatment is similar in children with pyelonephritis. However, short-course therapy is superior for reducing the risks of drug-resistant infection recurrence.

Comparison between short-course and long-course antimicrobial treatments for acute cholangitis with gram-positive coccus bacteremia after endoscopic retrograde cholangiopancreatography

BACKGROUNDThe optimal duration of antimicrobial treatment for acute cholangitis complicated by gram-positive coccus (GPC) bacteremia remains unclear. The Tokyo Guidelines 2018 recommended 14 days of antimicrobial treatment following adequate source control measures; however, evidence supporting this recommendation is limited, and deviations from real-world practice are often observed.AIMTo evaluate the efficacy and safety of shorter antimicrobial treatments for acute cholangitis complicated by GPC bacteremia.METHODSAdult patients with acute cholangitis complicated by GPC bacteremia who underwent endoscopic retrograde cholangiopancreatography between July 2003 and December 2023 were included. Patients were categorized into two groups based on the duration of effective antimicrobial treatment: (1) Short-course treatment (SCT) (< 14 days); and (2) Long-course treatment (LCT) (≥ 14 days). The outcomes assessed included mortality, recurrence, reinfection with the same organism related to the cholangitis, and length of hospital stay.RESULTSA total of 44 patients were included in the study: (1) 19 patients in the SCT group; and (2) 25 patients in the LCT group. The median duration of antimicrobial treatment was 9 days [interquartile range (IQR): 2.5-11.0 days] and 16 days (IQR: 15.0-19.0 days) in the SCT and LCT groups, respectively, with a statistically significant difference (P < 0.05). No significant differences were observed in 30-day mortality, cholangitis recurrence, or reinfection with the same organisms within 3 months. However, the length of hospital stay was shorter in the SCT group (median: 12.0 days vs 14.0 days, P = 0.092).CONCLUSIONFor acute cholangitis complicated by GPC bacteremia, shorter antimicrobial treatment may be a viable option following appropriate biliary drainage. Further studies with larger sample sizes are warranted.

Paradoxical responses to modified, all-oral shorter treatment of tuberculosis in non-immunocompromised patients: Cases from Armenia.

BackgroundThe previous publications presented paradoxical responses to anti-TB treatment in non-immunocompromised patients. Treatment for extra-pulmonary tuberculosis was associated with the majority of these responses.ObjectivesIn this paper, we present three cases of paradoxical radiological worsening in the HIV-negative patients receiving new modified, all-oral shorter regimens for pulmonary tuberculosis.MethodsThe treatment effectiveness was assessed based on the radiological and bacteriological examinations. Each of the three patients was adherent to treatment.ResultsAnti-TB therapy was effective in all of the cases, evidenced by bacteriological response. After initiation of treatment, the chest X-rays showed increased infiltration in the lungs. The patients continued treatment without adjustments of the shorter regimens. The following chest X-rays revealed positive dynamics. Despite the lack of specific therapeutic interventions to address radiological deterioration, the shorter treatment courses were successful. This means that radiological worsening detected in the middle of shorter treatment does not always indicate that anti-TB chemotherapy is ineffective.ConclusionParadoxical deterioration of chest X-ray findings may happen in HIV-negative patients receiving shorter regimens for rifampicin-resistant pulmonary tuberculosis but this worsening is not a reliable indicator for treatment outcome prediction. Additional therapeutic interventions or modifications of the chemotherapy regimens are not always necessary.

Epidemiological and clinical aspects of syphilis incidence in the Russian Federation and the Republic of Uzbekistan: comparative analysis

The Soviet model of healthcare was characterized by the centralization of state medicine, which made it possible to effectively deal with mass epidemics, including STIs. After the collapse of the USSR, the dermatovenereological services of the Russian Federation and the Republic of Uzbekistan actively developed and improved, developing new effective methods of treatment and prevention of skin diseases and STIs and introducing them into healthcare practice, which ensured the maintenance of epidemiological well-being. The article presents the results of a retrospective comparative study of syphilis incidence rates in two countries, including an analysis of the earliest, most epidemiologically dangerous clinical forms. It was found that starting in 2019, the incidence of early syphilis in the Republic of Uzbekistan began to exceed the same indicator in the Russian Federation, while previously this indicator was higher in Russia. An analysis of syphilis cases in various age and gender populations by clinical forms of the disease demonstrated an increase in late and unspecified forms in Russia among the male population over the age of 40, while in Uzbekistan there was an increase in the number of cases of early latent syphilis among the same age group. As a result of the study of regulatory documents regulating algorithms and principles of management of patients with syphilis, differences in laboratory diagnostic algorithms and treatment regimens were revealed, namely lower dosages of drugs and shorter treatment courses for patients with syphilis in the Republic of Uzbekistan compared with those in the Russian Federation.

Analysis of the trend in the burden of tuberculosis in China from 1990 to 2021

Objective: To assess the burden and development trends of tuberculosis (TB) in China from 1990 to 2021 to provide a reference for TB prevention strategies. Methods: Utilizing the 2021 Global Burden of Disease Study data, the study evaluates the burden of TB and latent TB infection (LTBI) in China using age-standardized incidence, prevalence, disability-adjusted life years (DALYs), and infection rates. The Joinpoint regression model was employed to analyze changing trends, and the autoregressive moving average model was integrated to forecast multidrug-resistant TB incidence and LTBI infection rates from 2022 to 2030. Results: In 2021, the age-standardized TB incidence in China was 36.28 per 100 000, the age-standardized prevalence was 30 557.45 per 100 000, the age-standardized DALY rate was 76.22 per 100 000, and the LTBI age-standardized infection rate was 30.48%. Compared to 1990, these figures dropped by 66.72%, 2.82%, 89.41%, and 2.47%, respectively. The age-standardized incidence, prevalence, DALY rate, and infection rate were elevated in individuals aged ≥70 years, and the TB burden was greater in males than in females. The age-standardized TB incidence declined between 1990 and 2021, while the proportion of multidrug-resistant TB patients among newly diagnosed cases, nationwide rose from 3.11% (36 367/1 167 807) in 1990 to 4.12% (25 431/617 725) in 2021. The LTBI age-standardized infection rate exhibited a fluctuating declining trend, averaging a decrease of 0.09%. Predictions for 2022-2030 indicate that China's multidrug-resistant TB incidence will decline slowly, and the LTBI infection rate will initially rise and then gradually fall, reaching 1.10/100 000 and 31.11%, respectively, by 2030. Conclusions: The TB burden in China declined from 1990 to 2021, but TB prevalence and LTBI infection rates remain high, especially among multidrug-resistant cases, males, and the elderly. Implementing systematic LTBI interventions, enhancing early detection/diagnosis in key populations such as the elderly, and promoting short-course treatments are recommended.

Automated VMAT planning for short-course radiotherapy in locally advanced rectal cancer

PurposeThis study aims to develop a fully automated VMAT planning program for short-course radiotherapy (SCRT) in Locally Advanced Rectal Cancer (LARC) and assess its plan quality, feasibility, and efficiency.Materials and methodsThirty LARC patients who underwent short-course VMAT treatment were retrospectively selected from our institution for this study. An auto-planning program for neoadjuvant short-course radiotherapy (SCRT) in LARC was developed using the RayStation scripting platform integrated with the Python environment. The patients were re-planned using this auto-planning program. Subsequently, the differences between the automatic plans (APs) and existing manual plans (MPs) were compared in terms of plan quality, monitor units (MU), plan complexity, and other dosimetric parameters. Plan quality assurance (QA) was performed using the ArcCHECK dosimetric verification system.ResultsCompared to MPs, the APs achieved similar target coverage and conformity, while providing more rapid dose fall-off. Except for the V5Gy dose level, other dosimetric metrics (V25 Gy, V23 Gy, V15 Gy, Dmean, etc.) for the small bowel were significantly lower in the AP compared to the MP (p < 0.001). Additionally, the dosimetric parameters for the bladder, pelvic marrow, and femoral head were also lower in the AP, except for the V25Gy for the bladder. The MUs of the AP were approximately 4% lower than those of the MP. The AP showed high consistency in dosimetric parameters across five organs at risk (OARs).ConclusionWe developed a fully automated, feasible SCRT VMAT planning program for LARC. This program significantly enhanced plan quality and efficiency while substantially reducing the dose to OARs.

Impact of the presence of a prosthetic implant and transition to oral stepdown therapy on relapse rates and mortality in uncomplicated Staphylococcus aureus bacteremia treated with 14 days of antibiotics: a retrospective cohort study.

The aim of this single-center, retrospective observational study was to evaluate the effects of having a prosthetic implant (PI) and of changing from intravenous to oral antibiotics (oral stepdown therapy [OST]) on the risk of relapse in patients with otherwise uncomplicated Staphylococcus aureus bacteremia (SAB) treated with antibiotics for 14 days. The primary outcome was the 90-day SAB relapse rate in patients with and without a PI. Secondary outcomes were 90-day mortality among patients with or without a PI and 90-day SAB relapse and mortality in patients who had OST. We included 188 consecutive patients with SAB without metastatic foci and with a planned antibiotic treatment duration of 14 days: 58 (31%) had a presumed uninfected PI, and 108 (57%) had OST. Four patients (2%) relapsed, and 25 patients (13%) died. Patients with a PI were more likely to have diagnostic tests performed. In the univariate analysis, the presence of a PI (odds ratio [OR] 7 [95% confidence interval {CI} 0.9-144.0]) and OST (OR 0.7 [95% CI 0.1-6.2]) were not associated with 90-day relapse. In the multivariable analysis, the presence of a PI (adjusted odds ratio [aOR] 1.3 [95% CI 0.5-3.7]) and OST (aOR 0.5 [95% CI 0.2-1.4]) were not predictive of 90-day mortality. In a setting where full diagnostic workup and close follow-up can be ensured, the presence of a PI and OST did not seem to be associated with an increase in 90-day mortality in patients with otherwise uncomplicated SAB. Although the relapse rate was low overall, there was a non-significant trend toward a higher risk of relapse in patients with a PI.IMPORTANCEThis retrospective study provides reassuring real-world data supporting a short 14-day treatment course for SAB in patients with PIs. In an era of increasing antimicrobial resistance worldwide, these retrospective findings support the perspective that not all PIs are systematically infected. Prolonged antibiotic therapy may therefore not be routinely needed if infection is excluded and thorough evaluation for dissemination performed, accompanied by close clinical and biological monitoring. Early transition to oral therapy in this context, which has been implemented in our institution for years, does not appear to be associated with a higher risk of therapeutic failure. These findings align with the most recent literature on the subject.

О ЗНАЧИМОСТИ ФАКТОРОВ КАРДИОВАСКУЛЯРНОГО РИСКА ДЛЯ РАЗРЕШЕНИЯ ОСТРОГО ПОВРЕЖДЕНИЯ ПОЧЕК ПРИ ИНФАРКТЕ МИОКАРДА У МУЖЧИН МОЛОЖЕ 60 ЛЕТ

Acute kidney injury negatively affects the prognosis of myocardial infarction. Purpose of the study. To study the structural features of the main and additional risk factors for cardiovascular diseases and their importance for resolving acute kidney injury in myocardial infarction in males under 60 years old in order to clarify the prognosis, improve prevention and outcomes. Material and Methods. The study included males aged 38-60 years old with type I myocardial infarction complicated by acute kidney injury. The patients were divided into two age-matched groups. The study group consisted of 21 patients with restored renal function during follow–up (56 days), the control group consisted of 109 patients without it. A comparative analysis of the structure of the main and additional risk factors for cardiovascular pathology in the selected groups was performed, as well as an analysis of their impact on the likelihood of renal function recovery during the follow-up period. Results. The compared groups differed in the frequency of smoking (71.4% in the study group and 89.9% in the control group; p=0.02), overweight (71.4% and 55.0%, respectively; p=0.03), and obesity (28.5% and 48.6%; p=0.046), under the age of 45 years old (38.1% and 14.7%; p=0.01), hereditary hypertension (81.0% and 56.0%; p=0.03); myocardial infarction in summer (47.6% and 13.8%; p=0.002) and winter (14.3% and 43.1%; p=0.002) periods of unstable angina (9.5% and 44.4%; p=0.003); balloon angioplasty and stenting (42.9% and 20.2%; p=0.03), as well as bypass surgery (0% and 22.0%; p=0.02) of coronary arteries, concomitant chronic obstructive lung diseases (9.5% and 34.9%, p=0.02); uro- (0% and 11.9%, p=0.01) and cholelithiasis (0% and 2.8%, p=0.01) in the anamnesis. Conclusions. The probability of restoring kidney function increased in non-smoking males under 45 years old with a hereditary history of hypertension, overweight without obesity, in the summer, with a less aggressive and short course of coronary heart disease and adequate treatment. These factors should be used for predictive modeling of kidney function in myocardial infarction.

Sustained Organ Preservation in Patients With Rectal Cancer After Sequential Short-Course Radiation Therapy and Chemotherapy.

BackgroundNonoperative management in patients with rectal cancer with complete response to radiation therapy and chemotherapy is of increasing interest. Most of the data on nonoperative management have centered around patients treated with long-course chemoradiotherapy. The ability of short-course radiation-based treatment courses to achieve durable complete responses with sustained organ preservation is less defined. This study updates our institution's long-term experience with nonoperative management following upfront short-course radiation therapy and sequential/consolidation chemotherapy.MethodsWe retrospectively reviewed patients with nonmetastatic rectal cancer treated with sequential short-course radiation therapy and chemotherapy who reached complete response and were subsequently followed with nonoperative management. We report on disease control outcomes, including rates of regrowth and results of salvage surgery. We investigated characteristics associated with local tumor regrowth.ResultsOur study included 52 patients. The 2-year freedom from local regrowth for the entire cohort was 75%. Notably, patients with high-risk disease characteristics at diagnosis exhibited a trend toward a higher rate of local tumor regrowth. No patient with sustained clinical complete response developed metastatic disease. Of the twelve patients undergoing surgical salvage for regrowth of disease, ten were resected with complete/near-complete total mesorectal surgical specimens with negative margins.ConclusionsThe optimal approach to achieving sustained organ preservation through the use of radiation therapy and chemotherapy is not well defined. Our findings show the viability of neoadjuvant therapy incorporating short-course radiation therapy to achieve durable complete responses.

A Prospective Evaluation of a Three-Gene Host Response Signature to Classify Tuberculosis Severity in Children.

Children with non-severe TB may benefit from short-course treatment, but point-of-care tools are needed to stratify disease severity. We prospectively evaluated the Cepheid Xpert MTB-Host Response (HR) prototype cartridge for distinguishing TB severity in children with pulmonary TB (PTB) in The Gambia and Uganda. We included children <15 with microbiologically confirmed or clinically diagnosed unconfirmed PTB. Severity was defined using the World Health Organization (WHO) guidelines for a four-month, drug-susceptible regimen. Capillary or venous blood was tested with the HR cartridge for PCR-based detection of 3 mRNA genes and calculation of a TB score from cycle thresholds. We generated receiver operating characteristic curves with the TB score to classify severe TB and assessed if Xpert-HR could achieve the WHO target accuracy for treatment optimization (≥90% sensitivity, ≥70% specificity). Among 106 children, the median age was 4 years (IQR 1-7), 56.6% were female, and 13.2% were living with HIV. In all children with PTB, Xpert-HR achieved an AUC of 0.67 (95% CI 0.55-0.78), with 89.3% sensitivity (95% CI 71.8-97.7) and 29.5% specificity (95% CI 19.7-40.9,cutoff ≤ -0.60). By confirmation status, Xpert-HR approached the target accuracy in children with Confirmed TB, with 62.5% specificity (95% CI 24.5-91.5) at 91.7% sensitivity (95% CI 61.5-99.8, cut-off ≤ -1.349). Among children with Unconfirmed TB, specificity was lower (24.3%, 95% CI 14.8-36.0) at 93.8% sensitivity (95% CI 69.8-99.8, cutoff ≤ -0.450). Target accuracy was almost achieved in children 5-9 regardless of confirmation status (100% sensitivity [95% CI 71.5-100], 66.7% specificity [95% CI 43.0-85.4], cutoff ≤ -1.35), but specificity (28.2%, 95% CI 18.6-39.5) was lower for children < 5 (92.9% sensitivity, 95% CI 76.5-99.1, cutoff ≤ -0.550). Xpert-HR approached the target accuracy to stratify PTB severity in older children and those with Confirmed TB but had lower specificity in children with Unconfirmed TB. Child-specific signatures may be needed to improve performance in younger children with paucibacillary disease.

Short-course treatment for community-acquired pneumonia in adults aged less than 65 years in Japan: A descriptive study using large healthcare claims database.

Short-course treatment for community-acquired pneumonia in adults aged less than 65 years in Japan: A descriptive study using large healthcare claims database.

Comparative Efficacy and Safety of Short- Versus Standard-course Fluoroquinolone Treatment in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Meta-analysis of Double-blind Studies.

Comparative Efficacy and Safety of Short- Versus Standard-course Fluoroquinolone Treatment in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Meta-analysis of Double-blind Studies.

Short-course Versus Long-course Antibiotic Treatment for Ventilator-associated Pneumonia: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Short-course Versus Long-course Antibiotic Treatment for Ventilator-associated Pneumonia: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Changes in Tuberculosis Blood RNA Signatures During the Short-course Treatment of Rifampicin-resistant Tuberculosis

Changes in Tuberculosis Blood RNA Signatures During the Short-course Treatment of Rifampicin-resistant Tuberculosis

Promising immunotherapeutic treatments for colon cancer.

Colon cancer continues to predominate as one of the most common causes of morbidity and mortality worldwide due to its subtle symptomology and multifactorial etiology. Currently, the standard treatment approach involves surgical resection for localized tumors and adjuvant chemotherapy (AC) for cancers that have spread or invaded locally. Unfortunately, this treatment strategy may not be effective for advanced, metastatic stages of the disease or in instances of recurrence. However, advancements in immunotherapy have demonstrated promising results in the field of medical oncology, which could redefine the way patients and clinicians view the disease. These treatments have shown benefit and have the potential to be superior to the current interventions available for afflicted patients. The application of immunotherapy in conjunction with traditional treatments may improve the outcomes of patients suffering from colon cancer and decrease the burden this disease has on patients. Furthermore, more effective treatments in the form of conjunction immunological, surgical, and chemotherapeutic techniques may shorten treatment courses and lead to better long-term effects. This review paper investigates immunotherapeutic interventions for colon cancer, which include immune checkpoint inhibitors, oncolytic virotherapy, cancer vaccines, cytokine therapy, and CAR-T. Such a study might provide more information for clinicians to treat patients with colon cancer in the advanced stages or in recurrence.