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Letters to the Editor
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Tuberculosis
World TB Day, and TB is on the move again
From Mr J. A. Bell, FRPharmS
Readers might not be aware that 24 March is World
TB Day.
“Consumption”, as tuberculosis used to be called, was responsible
for one in five deaths from the 1600s to the early 1900s. When the first
antibiotics were introduced in the 1940s it seemed TB might be eradicated;
but inequitable access to drugs, inappropriate prescribing and poor compliance
have dashed that hope. Now TB is on the move again.
Extensively drug-resistant tuberculosis (XDR-TB) is now spreading worldwide.
XDR-TB, a practically untreatable form of the disease, is defined as
being due to bacteria resistant to the two most powerful first-line drugs,
rifampicin and isoniazid, and also resistant to any fluoroquinolone and
at least one of the three second-line injectable drugs.
The importance of a strong, viable pharmaceutical research industry,
able to develop and bring to market new antibiotics, vaccines and diagnostics,
is never more clear than in the context of TB.
Today’s most commonly used method of diagnosing TB is more than
100 years old. Today’s vaccine, which is more than 85 years old,
provides some protection against TB in children, but is unreliable against
pulmonary TB, the most common form. Furthermore the drugs used to treat
TB are more than 40 years old, and must be taken for six to nine months.
Whether or not patients are forcibly sent to an isolation unit, pharmacists
have a critical role to play. Drug supply management, patient counselling
and involvement in directly observed treatment (DOTS) programmes will
help limit drug resistance.
John Bell
New South Wales, Australia |
The
Pharmaceutical Journal