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A discovery of a new combination treatment against drug-resistant strains of TB could be one of the most promising developments in TB research since the discovery of isoniazid in the 1950’s.

This finding is reported by scientists from Albert Einstein College of Medicine of Yeshiva University in the February 27 issue of Science. 

In laboratory tests, researchers at the Albert Einstein College of Medicine in collaboration with  National Institute of Allergy and Infectious Diseases (NIAID) discovered that a two-drug combination not only inhibits the growth of normal TB but 13 XDR-TB strains  isolated from TB patients in laboratory culture medium. 

The drugs work in tandem: first, Clavulanate (Augmentin) inhibits an enzyme which normally shields TB bacteria from antibiotics; then Meropenem, an antibiotic sold by AstraZeneca, attacks the bacteria. 

Both drugs are already FDA-approved for adult and pediatric use and have excellent safety profiles. “It’s very clever,” said Dr. Anthony Fauci, director of the NIAID. One drug drops the bacteria’s defense, which “leaves the original drug with the capacity of doing what it’s supposed to be doing.”  

Currently standard TB treatment requires that a patient takes a combination of four antibiotics for a period of not less than six months. Treatment for XDR-TB is both toxic and takes a longer duration, with some courses lasting as long as two years and often resulting in confinement in special hospitals for patients.
This development comes at a time when the whole world is deeply concerned with the rate of emerging and development of multi-drug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB). 

The new treatment will inject a sense of hope in countries like South Africa, where in some areas; one in four TB cases is extensively drug resistant. 

But the treatment will not be available until enough trials have been conducted in human beings.  Trials slated for 2009 in South Africa and South Korea will test the potency of the drug combination in a smaller number of TB patients.

If the results are successful and funding is available, a trial involving a larger number of XDR-TB patients will be conducted.  Already, Einstein has filed a patent application for the new TB treatment.

Ministers from high M/XDR-TB burdened countries will meet on April 2009, in Beijing, China to discuss the alarming threat of MDR-TB.

The main objectives of this important meeting will be to build a global consensus and political commitment and to scale up the prevention and management of MDR-TB, which will spear head the development of a 5-year national strategic plan for MDR-TB, to be embedded within national TB and health sector plans.

A preceding call for action by community representatives coming out of the Stop TB Partners Forum in Rio de Janeiro, Brazil, in March 2009, will also be presented in Beijing.