Tuberculosis chemotherapy: current drug delivery approaches

Area of Science:

• Pharmaceutical Sciences
• Infectious Diseases
• Drug Delivery Systems

Background:

• Tuberculosis (TB) remains a major global health threat, particularly among young adults.
• Multi-drug resistant TB (MDR-TB) is escalating, posing significant challenges in both endemic and resurgent regions.
• High rates of human immunodeficiency virus (HIV) infection exacerbate TB prevalence and treatment complexity.

Purpose of the Study:

• To review current drug delivery strategies for tuberculosis chemotherapy.
• To highlight novel systems designed to improve patient outcomes by targeting infection sites or reducing dosing frequency.
• To address the need for improved oral drug delivery systems, specifically concerning rifampicin bioavailability in fixed-dose combinations.

Main Methods:

• Review of existing literature on advanced drug delivery systems for anti-tuberculosis agents.
• Fabrication and evaluation of novel carrier-based systems including implants and microparticulates.
• Development of a polymeric, once-daily, oral multiparticulate fixed-dose combination.

Main Results:

• Various novel drug delivery systems have been developed, showing promise in targeting TB infections and reducing dosing frequency.
• Existing fixed-dose combinations face challenges with unacceptable rifampicin bioavailability.
• A new oral multiparticulate system achieves segregated delivery of rifampicin and isoniazid, improving rifampicin bioavailability.

Conclusions:

• Advanced drug delivery systems offer significant potential for improving tuberculosis treatment efficacy and patient compliance.
• Addressing rifampicin bioavailability in oral fixed-dose combinations is crucial for effective TB chemotherapy.
• A novel polymeric oral multiparticulate fixed-dose combination represents a promising advancement for more efficient and safer TB treatment, particularly in resource-limited settings.