Can a new nitroimidazole knockout the unconquered tuberculosis?

• Main Authors: Dhyuti Gupta, Ajaya Kumar Sahoo, Alok Singh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Archives of Medicine and Health Sciences
• Subjects: multidrug-resistant tuberculosis; pa-824; extensively drug-resistant tuberculosis
• Online Access: http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2020;volume=8;issue=1;spage=79;epage=82;aulast=Gupta

Pretomanid (PA-824) is the latest drug to get approval from the United States Food and Drug Administration (FDA) for the treatment of tuberculosis (TB). The present article aims to review the efficacy, safety, and tolerability of pretomanid in the management of drug-resistant TB for which a PubMed search (from the year 2007 to 2019) was conducted using the keywords: TB, multidrug-resistant TB, extensively drug-resistant TB, pretomanid, and newly approved drugs by FDA and PA-824. We included English language articles related to efficacy, safety, and tolerability of pretomanid in drug-resistant TB. Pretomanid is active against both the actively multiplying and latent Mycobacterium tuberculosis bacilli. In nonmultiplying bacterial cell, it causes nitric oxide-mediated nonspecific cellular damages, and in dividing bacteria, it acts by blocking the mycolic acid synthesis, thus resulting in inhibition of cell wall production. Pretomanid has been approved recently for managing such cases, in combination with bedaquiline and linezolid. Current data demonstrate its efficacy, safety, and tolerability with improved outcomes. The advantages of this combination observed could prove beneficial in developing countries, where there is not only a high burden of drug-sensitive TB cases but also the incidence of drug-resistant cases are on the rise.