Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
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to that of isoniazid. 1162 It appears that the action is on both protein <strong>and</strong><br />
lipid synthesis, 1161 inhibiting fatty acid <strong>and</strong> mycolic acid synthesis. 1163<br />
Similar to the nitroimidazoles (to which metronidazole belongs), nitrofurans<br />
show substantial in vitro bactericidal activity against bacilli held in<br />
a hypoxic stationary phase. 1164<br />
Because the recently synthesized nitroimidazopyran compound acts<br />
against multidrug-resistant tubercle bacilli, 1161 it might prove a valuable<br />
agent in the future.<br />
Oxazolidinones<br />
Oxazolidinones are a class of protein synthesis inhibitors <strong>and</strong> include linezolid<br />
<strong>and</strong> eperezolid. 1165,1166<br />
Oxazolidinones have promising activity against a range of microorganisms<br />
including, <strong>and</strong> other than, M. tuberculosis. 1166<br />
Oxazolidinones appear to inhibit a step in the protein synthesis. 1167 It<br />
has been proposed that they inhibit protein synthesis by binding to the 50S<br />
ribosomal subunit. 1168<br />
In experimental animals, oxazlidinones appear to be rapidly absorbed. 1166<br />
Paromomycin<br />
Paromomycin is an aminocyclosidic antibiotic complex, isolated from S.<br />
rimosus <strong>for</strong>ma paromomycinus in 1959 in the Parke-Davies laboratories 1169<br />
in the same year as aminosidin was isolated from S. chrestomyceticus in<br />
the Farmitalia laboratories. It is also identical to catenulin, which was isolated<br />
from S. catenulae in 1952 in the Pfizer laboratories. Paromomycin<br />
is an antibiotic complex consisting of at least six antibiotics, <strong>and</strong> belongs<br />
to the neomycin family. 1170<br />
Its potential in the treatment of tuberculosis lies with the advantage<br />
that there is little cross-resistance with either streptomycin or with amikacin/<br />
kanamycin. Its early bactericidal activity indicates that it is at least as<br />
effective as amikacin. 1171 Its toxicity (similar to that of neomycin) may,<br />
however, preclude its prolonged parenteral use.<br />
Phenothiazines<br />
Phenothiazines are derivatives of methylene blue <strong>and</strong> are used in the management<br />
of psychosis. Originally, Paul Ehrlich had reported that methylene<br />
blue immobilized bacteria, <strong>and</strong> their evaluation as potential antimicro-<br />
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