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Insmed Incorporated Message Board

  • migraine_jane migraine_jane Feb 11, 2013 11:26 PM Flag

    Would Arikace be effective here?

    http://www.usnews.com/news/articles/2013/02/11/doctors-struggling-totally-drug-resistant-tuberculosis-south-africa

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    • I doubt that Arikace would be much use in XDR/TDR cases such as those highlighted by that article.

      When strains of TB are isolated which are resistant to the two main drugs used in routine TB therapy, an aminoglycoside such as amikacin is at the top of the list of the drugs used in the alternative regimen. The suggestion here is that strains of TB have been isolated which are resistant to aminoglycosides and all other drugs known to be effective against TB.

      But Arikace would really help in preventing the development of MDR and XDR TB in the first place. As the following extract from that article indicates, it is poor compliance with the routine TB regimen which allows the development of drug-resistant strains -

      "Partial treatment of TB is one of the most important causes of drug resistance, says Karin Weyer, coordinator of the World Health Organization's Stop TB department on drug resistance. Any time a patient stops treatment, surviving bacteria have already been exposed to some level of antibiotics and are more likely to be resistant if the patient relapses, she says.

      "The most important aspect of this is that we get the patient cured the first time around," Weyer says. "Every time a patient has to get treated again, you run the risk of amplifying resistance."

      That has led to the cases of totally drug-resistant tuberculosis (TDR) described in the Emerging Infectious Diseases journal. Paul van Helden, director of South Africa's Centre of Excellence for Biomedical TB Research and one of the authors of the study, says it was only a matter of time before tuberculosis developed resistances to the last remaining effective antibiotics. TDR has previously been found in India, Iran, and Italy, but appears to be most prevalent in South Africa."

 
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