OVERVIEW OF NEW ANTI TB DRUGS

The emergence of multi-drug-resistant strains of M. tuberculosis makes it  necessary for the discovery of new drugs, and also implement other modalities of treatment. Eperezolid and linezolid  are  oxalidinones which are in phase II clinical trials. Other oxalidinones like AZD5847 and  PNU100480  are being evaluated in a phase I trials.  Regimens based on a higher dose of rifampin in humans are also being evaluated. Rifapentine (10 mg/kg) was approved for the treatment of pulmonary TB in 1998. Fluroquinolones like Ofloxacin, Ciprofloxacin, Lomifloxacin, levofloxacin, sparfloxacin and Moxifloxacin are effective against M. tuberculosis  and are in various phase of development. Newer  molecules like TMC207, nitroimidazoles like  PA-824 and OPC-67683 are  in phase II. Diamines  like SQ109 has shown to have  in vitro action  between SQ109 and isoniazid and especially rifampin. SQ609, a dipiperidine, which is an inhibitor of translocase, involved in cell wall synthesis, is in preclinical studies. Sudoterb (LL3858) is found to have bactericidal activity against both drug senstitive and  MDR-TB. BTZ-043 (NM4TB Consortium), FAS20013, LL3858, CPZEN-45, are also in various stages of development. New potential drug molecules and drug targets are also  being evaluated. New techniques like using FRIGATE,  and Nanocarriers, chemical investigations on the whole plants Gentiana, methanolic root bark extract of Leucophyllum, Cinnamic derivatives are being evaluated for their role in anti TB activity. Immunomodulation with 1, 25-dihydoxyvitamin D and resection of cavitary or badly damaged lung tissue  could be used as a adjuvant therapy in tuberculosis. Enumerous  vaccines are in various stages of preclinical development.