Abstract

PHARMACOTHERAPEUTIC EVOLUTION OF ANTITUBERCULOSIS DRUG-A REVIEW

Coulibaly Songuigama, Ouattara Mahama*, N. Guessan Jean Paul, Adouko Apleheni Eunice and Sanogo Mawa

ABSTRACT

Tuberculosis is a cosmopolitan human lung infection caused by Mycobacterium tuberculosis. It represents one of the main causes of death worldwide. The therapeutic management of this disease by antituberculosis drugs faces several obstacles such as low adherence, the long duration of treatment, adverse effects of the drugs and the existance of the latent tuberculosis caused by dormant bacilli. Furthermore, the drug treatment of co-infection HIV and tuberculosis resistant is in a situation of therapeutic deadlock. Therefore, it seemed worthwhile to make an inventory of antituberculosis drugs and have a better understanding of future therapeutic options. This study highlighted the existance of many "doubtful" non-drug treatments proposed to treat tuberculosis before the discovery of modern tuberculosis chemotherapy. Some of them suggested prayers, incantations (heal power of kings), or a simple rest combined with a balanced diet. Others less gentle methods such as the injection of air into the lungs recommended surgical treatments like thoracoplasty. Various treatment based on gold salts, cod liver oil or the sanatorium cures were also tested. The discovery of streptomycin in the 1940, was the beginning of the current anti-tuberculosis therapy. Indeed, research aimed at finding an alternative treatment, to overcome the Streptomycin resistance, led to the introduction in therapy of many other antituberculosis like Para-aminosalicylic acid (1944), Isoniazid (1952), the ethambutol (1957), Rifampicin (1967), the pyrazinamide (1980) and fluoroquinolones (1982). Moreover, in order to shorten the duration of treatment and to limit the the emergence and spread of resistance, combination of antituberculous drugs has been proposed and the treatment of tuberculosis has evolved from monotherapy to quadruple today. In addition, to deal with the appearance of poly-resistant strains and overcome the drawbacks existing tuberculosis drugs, research is underway to identify new biological targets and to develop antituberculosis of the future.

Keywords: Antituberculosis drugs, tuberculosis, Mycobacterium tuberculosis.