The respiratory system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Although a number of potential vaccines against tuberculosis are undergoing clinical testing, an effective vaccine is not currently available in the United States. Management of tuberculosis often requires prolonged treatment with powerful antimycobacterial drugs such as isoniazid, rifampin, and ethambutol. Unfortunately in recent years, the treatment of tuberculosis has been complicated by the rise of TB organisms that are resistant to one or more of the commonly used anti-tubercular agents. According to the WHO, globally in 2013, an estimated 480,000 people developed multidrug-resistant TB (MDR-TB). In cases of MDR-TB, mortality can be on the order of 70%–90%. Factors that affect immune function such as proper nutrition and management of other diseases are also essential for successful treatment of tuberculosis.
Water-based disease and microbial growth *
Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse in Routledge Handbook of Water and Health, 2015
The Mycobacterium avium complex (MAC) consists of at least twenty-eight serovars of two distinct species, M. avium and M. intracellulare. Pulmonary disease caused by MAC has dramatically increased in the United States over the last three decades (Kendall and Winthrop, 2013). The disease is most common among individuals over sixty years of age. Predisposing factors include age, chronic lung disease, bronchogenic carcinoma and AIDS (von Reyn et al., 2004). MAC can also cause pulmonary disease, osteomyelitis and septic arthritis in people with no known predisposing factors. Diseases caused by MAC can be life-threatening and infections are difficult to treat because of resistance to many antimycobacterial agents. It is believed that municipal drinking water systems are an important reservoir for MAC. They are among the most common bacteria identified in biofilms in chlorinated drinking water distribution systems and fixtures (e.g. shower heads) (Falkinham et al., 2004). Epidemiological investigations have associated water sources with infections by atypical mycobacteria. These bacteria can multiply in water that is essentially free of nutrients and they are relatively resistant to disinfection by chlorination, chloramines and UV light.
Drug Allergy
Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial in Textbook of Allergy for the Clinician, 2021
Vancomycin allergies are rare, however about half of patients will experience cutaneous erythema, flushing and pruritus (red man syndrome) due to non-IgE mediated mast cell degranulation (Polk et al. 1988). This type of reaction is dependent on the infusion rate so treatment can often resume at a slower rate. Both type I and mild type IV hypersensitivity reactions to clindamycin and fluoroquinolones can occur, but the causative metabolites are not well defined and there are no validated diagnostic tests for these agents. Macrolide allergies are generally rare. Immunologic reactions to several antimycobacterial drugs including isoniazid, ethambutol, pyrazinamide and rifampicin are not rare and include a diverse number of the immunologic drug reactions.
New advances in the treatments of drug-resistant tuberculosis
Published in Expert Review of Anti-infective Therapy, 2023
Mohanad Mahmoud, Yurong Tan
1-Cinnamic acid derivatives are produced from Kaempferia galangal and 2- Bisbenzylisoquinolone alkaloids are produced from Tiliacora triandra 3-Iridoids. Several iridoids have been extracted from Plumeria bicolor [24]. In India, several Indian herbs have been found to illustrate the sensitivity of the growth of Mycobacterium tuberculosis H37Ra as shown in Table 2 below [26]. In Cameroon, six different medicinal plants showed in vitro antimycobacterial activity. The antimycobacterial activity of these plants was tested against virulent strain H37Rv. The minimum inhibitory concentrations (MICs) of the six extracts tested were all effective against M. tuberculosis, as shown in Table 3 [27]. In Ghana, several traditional medicinal plants have been used as therapeutic agents against TB. Different plant families produced different amounts of anti-TB agents, with the Amaryllidaceae family producing the most medicinal plants. Leaves are the most common plant parts used to treat tuberculosis in Ghana. Local Ghanaian communities use water to extract anti-TB drugs from plant parts [22]. Table 5 below illustrates the most common medicinal plants used for TB in Ghana Table 4.
A retrospective study on tolerability and complications of bacillus Calmette-Guérin (BCG) instillations for non-muscle-invasive bladder cancer
Published in Scandinavian Journal of Urology, 2019
Antti Nummi, Riikka Järvinen, Jukka Sairanen, Kaisa Huotari
Patient characteristics, clinical presentations, and antimycobacterial therapy for the BCG infections are presented in Table 4. We found seven patients with systemic and five with local BCG infections. Persistent fever, reported on with five patients, was the most common manifestation among patients with systemic infections. Persistent cough without fever was reported in one patient with systemic infection, and one systemic infection diagnosis was an incidental radiological finding. Epididymitis, nephritis, or lymphadenitis were found in local infections. Isoniazid and rifampin combined with ethambutol was the antimycobacterial therapy for 10 patients. One patient received only isoniazid and rifampin as a treatment for BCG infection. Levofloxacin combined with isoniazid and rifampin was used in one patient. Two patients had received pyrazinamide even though the BCG strain is always resistant to pyrazinamide. Antimycobacterial therapy was combined with appropriate surgical therapy (orchiectomy, lymphadenectomy) for three patients who presented with local infections. All of the patients resolved, except for one, who died of a mycobacterial infection.
Drug-induced Uveitis in HIV Patients with Ocular Opportunistic Infections
Published in Ocular Immunology and Inflammation, 2020
Ilaria Testi, Aniruddha Agarwal, Rupesh Agrawal, Sarakshi Mahajan, Alessandro Marchese, Elisabetta Miserocchi, Vishali Gupta
Rifabutin is commonly used for prophylaxis of Mycobacterium avium complex (MAC) in patients with AIDS and low CD4 + T cell count, and for treatment of non-tuberculous mycobacterial disease in combination with other drugs. Rifabutin is also recommended in the treatment of pulmonary tuberculosis in HIV patients. The activity of the drug is similar to that of rifampicin, another antimycobacterial agent derived from rifamycin, which is widely used in standard multidrug antitubercular treatment in combination with isoniazid, pyrazinamide, and ethambutol. Since HIV-infected patients on CART are at risk of drug–drug interaction, rifabutin is usually administered in place of rifampicin, being a less potent inducer of the cytochrome P450 drug metabolizing enzymes.33 Recommended dose of rifabutin for prophylaxis is 300 mg/daily, but it is increased to 450–600 mg/daily in the treatment of atypical micobacteria infections.