A shorter and simpler drug treatment would be a huge advance for tuberculosis as it occurs in resource-limited settings with poor public health infrastructure and is a difficult infection to treat requiring six months of multiple antibiotics to cure it .
Testing whether two simple clinical measurements might help identify which TB patients could benefit from shorter treatment, researchers at Case Western Reserve University and University Hospitals (UH) Case Medical Center report that these measurements failed to work in a study published online by the American Journal of Respiratory and Critical Care Medicine.
The two measurements were absence of a cavity (an abscess caused by TB) in the lungs (detected by chest X-ray) and failure to grow TB bacteria from the sputum once drug treatment was started (sputum culture conversion). The Phase III clinical trial involved TB patients in Uganda (Africa), Brazil (S. America) and the Philippines (Asia) and was conducted by the Tuberculosis Research Unit (TBRU) at Case Western Reserve University and UH Case Medical Center in Cleveland, the only National Institutes of Health supported TB unit in the U.S.
"To better identify risk factors for why treatment fails in a subset of TB patients will require novel approaches and further research so that we can determine quickly (not having to wait for two years after completing six months of drug treatment to measure relapses) not only the effectiveness of new TB drugs or regimens but also who will benefit most from these shortened and simplified TB treatment regimens," added John L. Johnson, MD, first author of the study and an infectious disease expert with Case Western Reserve University School of Medicine and UH Case Medical Center.