New treatment regimens for drug-sensitive tuberculosis: Fluoroquinolones and enhanced rifamycins

Abstract

New drugs for drug-sensitive tuberculosis (TB) could resolve many of the current challenges facing TB treatment programs. Newer fluoroquinolones have demonstrated considerable promise in murine models of TB treatment. Some, but not all, recent phase 2B clinical trials suggest that these agents could support TB treatment regimens of reduced duration. Phase 3 treatment-shortening trials based upon the addition of C8-methoxy fluoroquinolones are now underway in sub-Saharan Africa and elsewhere. Murine data have also suggested that higher-dose or higher-frequency use of currently available rifamycins (rifampin, rifapentine) could support treatment-shortening regimens. Phase 2B trials of high-dose rifampin regimens and of higher-dose/higher-frequency rifapentine-based regimens will begin soon on multiple continents. Results from these phase 2B efforts will guide the development of phase 3 trials of ultra-short TB therapies. © 2008 The Authors.