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- Mycobacterium tuberculosis and the response of its host
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2. The pathogenesis of tuberculosis
- Dr. William R. Bishai
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3. Immune response and rational development of vaccines and biomarkers
- Prof. Dr. Stefan H. E. Kaufmann
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4. Molecular mechanisms of drug resistance in M. tuberculosis
- Dr. Daniela Cirillo
- The epidemiology of tuberculosis
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5. The basic epidemiology of tuberculosis (TB)
- Dr. David Dowdy
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6. Global epidemiology of TB
- Dr. Philippe Glaziou
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7. Social determinants of tuberculosis
- Dr. Knut Lönnroth
- The control of tuberculosis
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8. Treatment of tuberculosis
- Dr. Jean-Pierre Zellweger
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9. The End TB Strategy towards TB elimination 1
- Dr. Mario Raviglione
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10. The End TB Strategy towards TB elimination 2
- Dr. Mario Raviglione
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11. Financing TB care and control
- Dr. Christopher Fitzpatrick
- Dr. Andrea Pantoja
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12. Tuberculosis and COVID-19
- Prof. Giovanni Battista Migliori
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13. Multidrug resistant tuberculosis (MDR-TB): an update
- Dr. Simon Tiberi
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14. Impact of HIV on tuberculosis in the developing world and how to manage it
- Prof. Anthony D. Harries
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16. TB in children
- Prof. Ben J. Marais
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17. Community engagement in tuberculosis care
- Ms. Lana Syed
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18. India: the epicentre of global TB control
- Dr. Madhukar Pai
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19. Community engagement in TB care
- Dr. Haileyesus Getahun
- Research and development for new approaches in the control of tuberculosis
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20. Development of new regimens for tuberculosis
- Dr. Zhenkun Ma
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22. Pharmacometrics in tuberculosis
- Prof. Charles A. Peloquin
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23. Extrapulmonary tuberculosis
- Dr. Scott Heysell
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24. The role of surgery in tuberculosis management
- Dr. Richard Zaleskis
- Archived Lectures *These may not cover the latest advances in the field
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25. The development of current treatments for tuberculosis
- Dr. Andrew Nunn
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26. The pathogenesis of tuberculosis
- Dr. William R. Bishai
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27. Basics of tuberculosis epidemiology
- Prof. Frank Cobelens
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29. The international approach to the control of tuberculosis
- Dr. Mario Raviglione
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30. Public-private mix for TB care and control
- Dr. Mukund Uplekar
Printable Handouts
Navigable Slide Index
- Introduction
- No conflict of interest
- Content
- History of (chemo)therapy of tuberculosis
- Some serious attempts before antibiotics
- The aims
- The problems
- How to evaluate the efficacy
- An expert opinion in 1946!
- The main problem
- Chronology of drug discovery
- Historical trials
- Streptomycin: first BMRC controlled trial
- The search for the best combination and duration
- The Madras trials (from 1966)
- The East African / BMRC trials
- The proof of the pudding is in the relapse rate
- Trials with different durations of therapy: East & Central Africa
- Trials with different durations of therapy: Hong Kong
- Trials with different durations of therapy: Madras
- Trials with different durations of therapy: optimal regimen
- Trials of shorter regimens: Johnson
- Trials of shorter regimens: Gillespie
- WHO guidelines
- The current standard regimen (since 1976)
- WHO current recommendations 2017: drug susceptible pulmonary TB and duration
- WHO current recommendation 2017: drug susceptible pulmonary TB and dosage
- The main anti-TB drugs: isoniazid (INH, H)
- Rifampicin (RMP, R)
- Pyrazinamide (PZA, Z)
- Ethambutol (EMB, E)
- Quinolones
- Injectables
- Linezolid (LNZ, L)
- Bedaquiline (TMC207, BDQ, B)
- Delamanid (OPC-67683, DLM, D)
- Pretomanid (PA 824, Pa)
- Special situations
- Treatment of CNS TB: regimen
- Treatment of CNS TB: a study
- WHO current recommendations 2017: CNS and pericarditis
- Treatment for TB in children
- Treatment of TB during pregnancy
- WHO current recommendations 2017: PLHIV
- WHO current recommendations 2017: ART
- The drug level and therapeutic margin
- Treatment of TB: the problem of adherence
- Factors affecting adherence to treatment
- WHO current recommendations 2017: patient support
- Supervision of TB treatment (Bénin)
- Treatment of TB: some other options
- Can we increase the local activity of anti-TB drugs?
- Aerosol formulation of anti-TB drugs
- Antituberculosis drugs by inhalation
- Adjuvant therapy for tuberculosis
- The ideal treatment and the current situation
- Conclusions
- TB drugs and palatability
- Thank you!
Topics Covered
- History of chemotherapy
- Current first-line drugs and mechanisms of action
- Main second-line drugs
- Standard regimens
- Special situations: pregnancy, children, drug interaction
- Person-centered approach, DOT
- Other options for tuberculosis treatment
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Zellweger, J. (2021, September 29). Treatment of tuberculosis [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 21, 2024, from https://doi.org/10.69645/FULV5792.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Jean-Pierre Zellweger has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Infectious Diseases
Transcript
Please wait while the transcript is being prepared...
0:00
Hello everybody, welcome to this webinar session.
My name is Jean-Pierre Zellweger, I am a Swiss pulmonary physician,
former chief of the TB clinic at the University Hospital in Lausanne,
now retired and working part-time as a consultant for
the TB Competence Centre of the Swiss Lung Association in Bern, Switzerland.
0:24
I have no conflict of interest for this presentation, and as a clinician
I will present the issue of TB treatment from a clinical point of view,
which may sometimes be oversimplified.
0:38
The content of my presentation will speak about: the history of chemotherapy;
present the current first-line drugs and mechanisms of action;
some of the main second-line drugs;
the standard regimens;
I will address some special situations like pregnancy, children, or CNS tuberculosis;
I will speak about the person-centred approach and directly observed therapy;
and mention, at the end, some other options for TB treatment.
1:09
The history of chemotherapy of tuberculosis is ancient, but for some authors like Laennec,
the cure of phthisis (which is tuberculosis) is possible for nature, but it's not for medicine.
Laennec considered all remedies proposed for the treatment of TB as inefficient, which was actually true in 1819.
For Robert Koch, after the failure of tuberculin trials,
prevention and vaccination were the only prospect for a cure of TB.
My predecessor at the TB dispensary in Lausanne declared - in 1940 - that,
"We are not here for healing TB", but this was before the advent of chemotherapy.
All attempts at the medical treatment of tuberculosis by calcium, gold salts,
sulfonamides and others, failed until the discovery and use of streptomycin in 1946.