|Year : 2005 | Volume
| Issue : 4 | Page : 142-145
Prevention of resistance to new anti-TB drugs
Department of TB & Respiratory Diseases,Dr. D. Y. Patil Medical College, Pimpri, Pune., India
H G Varudkar
Department of TB & Respiratory Diseases,Dr. D. Y. Patil Medical College, Pimpri, Pune.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Varudkar H G. Prevention of resistance to new anti-TB drugs. Lung India 2005;22:142-5
The book Time Bomb  has described an incidence about sparfloxacin, which was initially described as "a new drug against TB - the first new drug in decades". After some deliberations this drug was not marketed for TB management at all. The reason for this was only profits. "In a way, its approval for treating TB would be a kiss of death for the drug".
Due to this reason I realize the following grave situation:
- There are large numbers of new effective antimicrobial drugs present in the market; and probably a larger number will be coming in future. Due to the policies of pharmaceutical firms, this aspect of antimicrobial activity of these drugs will not be emphasized or even mentioned in the information-literature supplied by them.
- All of the medical practitioners will be unknowingly prescribing these drugs for many nonspecific infections; which may include mycobacterial infection as well. Consequently, there is a great danger of development of resistance in those exposed mycobacteria. We therefore, may lose many effective weapons against multi drug resistant mycobacteira without realization.
I have following suggestions to prevent this inadvertent resistance in mycobacteria:
a) Research level: A pharmaceutical firm due to certain reasons may concentrate on the research in a specific direction avoiding problematic bacteria like mycobacteria. I suggest here that when any new antimicrobial drug is discovered and studied, it should be mandatory for the firm to conduct a study-efficacy of the drug against mycobacteria; and its report has to be included in the final reports.
b) License level: when any pharmaceutical firm applies for the manufacturing or marketing of these drugs, the administration should apply following conditions:
- Efficacy of the said drug against mycobacteria has to be included in the format of application.
- The concerned firm should undertake, that while marketing, all the information will be provided to all the medical practitioners with special emphasis on the anti-mycobacterial activity of the drug.
c) Marketing level: All the informative literature supplied by the Pharma Company must include following precautionary warning in bold & distinctive letter type:
Precautionary warning: This drug has mycobacteriocidal/mycobacteriostatic activity. Please exercise great care if mycobacterial infection is not ruled out.
d) Medical practitioners level:
- Every medical practitioner must refrain from using these drugs while instituting empirical antibacterial therapy.
- If the drug is inevitable in some conditions, other antimycobacterial drugs must be used simultaneously to prevent emergence of drug resistant tuberculosis.
| References|| |
|1.||Reichman L B, Tanne J.H. "Why are there no new drugs or vaccines for TB?". In "Timebomb", Tata McGraw-Hill , Edition 2002, p. 171 |