Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

A new antibiotic appears effective against multidrug-resistant TB

21.05.2003


A new antibiotic appears effective against deadly strains of tuberculosis resistant to nearly all currently available treatments for the infectious disease. The antibiotic, called linezolid, recently saved the lives of four women and one girl who were gravely ill with multidrug-resistant tuberculosis and who were hospitalized at Bellevue Hospital in New York City, according to a report by physicians at NYU School of Medicine. The patients, ranging in age from 10 to 54, were resistant to at least eight, and up to 14, anti-TB therapies.



"This group of patients were our most difficult to treat," says William Rom, M.D., Professor of Medicine and Environmental Medicine at NYU School of Medicine. "They were in a lot of trouble, and we had run out of treatment options."

Dr. Rom is also Chief of the Chest Service at Bellevue Hospital, an affiliate of NYU Medical Center. Bellevue’s Chest Service, which recently celebrated its 100th anniversary, is regarded as the birthplace of pulmonology. Chest Services originally were devoted to patients with TB, a disease that targets the lungs.


"Trying the linezolid was a real act of desperation," says Timothy Harkin, M.D., Assistant Professor of Medicine and Assistant Director of Bellevue’s Chest Service. "This certainly seems like a promising medication for multidrug-resistant TB and there is a continuing need for new antibiotics for this disease."

Drs. Harkin and Rom say that further studies are needed to confirm their case reports, and hope the drug will be tested in large clinical trials sponsored by the World Health Organization. The NYU physicians presented the cases to their colleagues on Wednesday, May 21, at an international conference held by the American Thoracic Society in Seattle.

Multidrug-resistant TB is pandemic and certain places in the world, such as Eastern Europe, Estonia, Latvia, and jails in Russia, are regarded as hot spots where the prevalence is alarmingly high. No new drugs that might be effective in treating resistant strains are in clinical trials, and many researchers are not optimistic that new therapies will be available anytime soon.

Tuberculosis is one of the world’s greatest killers, taking the lives of two million people each year. Some eight million new cases of TB arise each year and currently more than one-third of the world’s population is infected with the bacterium causing TB, according to the World Health Organization. The microbe can lie dormant for decades, and then suddenly activate and attack the lungs (producing a bloody cough), the spinal cord, kidney and other parts of the body.

Typically, TB is cured with six months of therapy with antibiotic pills. But drug-resistant strains of the bug require 18 to 24 months of treatment with powerful multidrug regimens along with medical support to manage the regimens’ side effects. The cost of treatment for drug-resistant TB exceeds $250,000, which is up to 20 times the cost of the standard six-month therapy. Drug resistant strains of the bug arise when patients do not finish the entire course of their therapy or are treated with the wrong combination of drugs.

Linezolid (brand name Zyvox) is a new class of antibiotics that was approved by the Food and Drug Administration to treat certain strains of bacteria resistant to standard antibiotics such as penicillin and methicillin, and to more powerful drugs like vancomycin. It is not approved to treat drug-resistant TB.

However, Bellevue Chest Service doctors decided to try linezolid when all other available therapies, including the most powerful drugs yet available for drug-resistant TB, failed to improve the health of the five patients at Bellevue. Linezolid had been shown in laboratory studies to have an effect against the TB microbe.

The patients took linezolid twice a day in pill form for nine to 33 months. Four patients also received interferon gamma (a type of immune system modulator) in an aerosolized form three times a week. Following the treatment, there was no sign of the TB microbe in sputum from the patients’ lungs. Moreover, the physicians said that the drug did not seem to be associated with many severe side effects. Two patients continue on treatment and are doing well. One patient relapsed two years after completing the treatment, but died of unrelated factors before she could be re-treated.

In the early 1990s, New York City was the epicenter of a TB resurgence in the United States, fueled partly by the HIV epidemic, a deteriorating public health infrastructure, and an increase in poverty and homelessness. Insufficient treatment led to an alarming rise in drug-resistant strains of the disease. At its peak in 1992, New York City reported 441 drug-resistant cases out of 3,811 new cases of TB in the city. Since that time, the number of cases has decreased dramatically after a concerted effort was made to ensure that all patients took their medications for the fully prescribed period of time through a method called directly observed therapy. In 2001, the latest year for which data is available, 24 patients had multidrug-resistant strains of TB out of 1,261 new cases of TB reported in New York City.

In addition to Drs. Rom, Harkin, the other NYU School of Medicine physicians who collaborated on the case reports are: Nicos Hadjiangelis, M.D., a pulmonary and critical care fellow, Eric Leibert, M.D., Assisant Professor of Clinical Medicine, and Rany Condos, M.D., Assistant Professor of Medicine.

Pamela McDonnell | EurekAlert!
Further information:
http://www.med.nyu.edu/

More articles from Health and Medicine:

nachricht Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University

nachricht Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Subaru Telescope helps pinpoint origin of ultra-high energy neutrino

16.07.2018 | Physics and Astronomy

Barium ruthenate: A high-yield, easy-to-handle perovskite catalyst for the oxidation of sulfides

16.07.2018 | Life Sciences

New research calculates capacity of North American forests to sequester carbon

16.07.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>