Use of a novel combo drug treatment cured a young patient's life with drug-resistant tuberculosis.
The result marks the first known clinical use of this treatment for XDR-TB, the most deadly form of the disease.
"It was extremely rewarding to see that our in vitro biochemical studies would contribute to a successful clinical outcome for this seriously ill girl. I applaud the courage of the Belgian physicians," said John Blanchard, the Dan Danciger Professor of Biochemistry at Einstein, who led the development of the new therapy.
Blanchard and his colleagues reported in the February 27, 2009 issue of Science that a combination of clavulanate and meropenem inhibited the growth of drug-susceptible laboratory strains of TB as well as XDR-TB strains isolated from TB patients.
Clavulanate-meropenem therapy for XDR-TB has not yet been evaluated in clinical trials.
In 2010, physicians at Hopital Universitaire Saint-Pierre in Brussels, Belgium, oversaw the care of a 14-year-old girl from Chechnya with XDR-TB.
The acutely ill and malnourished patient failed to respond to standard first- and second-line TB medications. Tests showed that her TB strain was extensively drug resistant.
As a last resort, the Belgian physicians decided to try clavulanate and meropenem, the combination therapy they had read about in Blanchard's Science paper.
"We had nothing to lose," wrote Marie-Christine Payen, leader of the Belgian team, in an e-mail to Einstein officials.
The girl showed clinical improvement after four weeks of therapy. After 11 weeks, her sputum tests were negative for TB, said the Belgian team.
The study was published in the Pediatric Infectious Disease Journal.