Treatment times for tuberculosis (TB) could be significantly reduced from six to four months using a higher dose of antibiotics, that is according to research from St George’s Hospital, University of London.
The study showed that a higher dose of the antibiotic rifampicin given over a shorter period of four months was safe to use in patients with TB, with no increase in side effects or toxicities.
Currently, TB treatment lasts for six months (as recommended by the World Health Organisation), which can present challenges for continued follow-up care. In addition, the number of patients who adhere to the treatment plan for the whole six months is suboptimal, increasing the risk of reoccurrence of the disease.
Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis that most often affects the lungs. Every year, around ten million people worldwide fall ill with TB, resulting in around 1.5 million deaths.
TB is preventable through vaccination and treatable with antibiotics.
However, given the antibiotics need to be taken over six months, healthcare support is needed to follow patients over this period, and adherence to the treatment plan can be difficult.
For a range of reasons, people do not always complete the course. Patients not completing their course of antibiotics can increase the risk of TB reoccurring and the risk of antibiotic-resistant strains developing, which can spread.
There are growing concerns about rising strains of tuberculosis that do not respond to the standard antibiotics used to treat it. Therefore, the results of the study indicate a shorter treatment period of four months could help increase the compliance rate among patients, ultimately leading to more cures, reduced transmission, a lower chance of developing resistance, and fewer deaths.
TB was once prevalent in the UK and across Europe, but better sanitation, healthcare, vaccination programmes, and antibiotics have helped reduce cases of the disease.
While TB is present all over the world, over half of cases occur in just eight countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines, and South Africa.
However, the UK cannot be complacent as cases are detected every year (in 2021, a total of 4,425 people were notified of TB), and with the growing threat of antibiotic-resistant TB strains, it is important cases are identified and treated effectively.
The TB vaccine used to be offered to secondary school children in the UK but was replaced in 2005 with a targeted programme for babies and children considered at higher risk of TB, as rates in the general population were so low.
This means keeping on top of TB and treating any cases in the community is crucial.
Professor Amina Jindani, Emeritus Professor of Tuberculosis Therapeutics at St George’s University of London, who led the trial, said, “Our research now presents a major milestone for TB treatment as it proves that a higher dose of widely available drugs over just four months is possible and safe.
This is good news for people diagnosed with TB; it simplifies their treatment, meaning they are more likely to complete the full course, giving them the best chance of being cured, while slashing the cost, which is a huge barrier in developing countries.”
If you have a cough that lasts more than three weeks, coughing up mucus (phlegm) or mucus with blood, feeling fatigued or exhausted, a high temperature or night sweats, a loss of appetite, weight loss, or feeling generally sick, you should see your GP right away. Children may also struggle to gain weight or grow.
(Photo credit: ThinkStock)
Rachel Kayani
