08 July 2016 - PRESS RELEASE
Traditional antibiotic is also effective against tuberculosis
An international team of scientists has had unexpected success in treating tuberculosis with a ß-lactam antibiotic that is approved for other indications. DZIF scientists from the Research Center Borstel were involved in the trial. It is currently published in the New England Journal of Medicine.
Worldwide, the number of patients diagnosed with difficult-to-treat multidrug-resistant tuberculosis (MDR-TB) rose dramatically from 47,000 in 2009 to 123,000 in 2015. New drugs are urgently required. However, developing such drugs is costly and bears economic risks for the pharmaceutical companies, and takes at least ten years. Additionally, there is the problem of resistance development: the first bacterial strain with resistance to the two latest drugs for multidrug-resistant tuberculosis (bedaquiline and delamanid) was identified in less than two years after the drugs were launched.
According to the scientists, an alternative to developing new tuberculosis drugs is to test drugs for tuberculosis treatment which have already been approved for other indications. For a long time, it had been believed that ß-lactam antibiotics, which are related to penicillin, are not effective in treating tuberculosis. A team from South Africa, Spain, Mozambique and Germany has now challenged this belief.
The physicians treated patients suffering from lung tuberculosis with the ß-lactam antibiotic meropenem for 2 weeks, before the start of their actual treatment. ß-lactam antibiotics are derived from penicillin and disrupt bacterial cell wall synthesis. In order to inactivate the tuberculosis bacteria’s defence mechanisms, the physicians additionally administered clavulanic acid. It inhibits ß-lactamase, a bacterial enzyme, making ß-lactam antibiotics ineffective. Under this combination treatment, the treated patients’ sputum bacterial load rapidly decreased. “This treatment was as effective as that with the standard drugs rifampicin and pyrazinamide,” explains Professor Christoph Lange, Medical Director of Clinical Infectious Diseases at the Research Center Borstel and DZIF scientist. “However, the trial was not designed to investigate the long-term effects of meropenem/clavulanic acid with regard to the chances of healing multidrug-resistant tuberculosis,” says Lange, dampening too high expectations.
The current discovery opens up a new field in clinical tuberculosis research: drugs that have already been approved could be tested for their efficacy against tuberculosis.
Diacon AH et al.: ß-Lactams against Tuberculosis – New Trick for an Old Dog?New England Journal of Medicine 2016 July 13th. DOI: 10.1056/NEJMc1513236
Prof Christoph Lange
Research Center Borstel
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