New Combined Drug Regimen for Complete Cure of Pulmonary Tuberculosis in Patient with Impaired Hepatocellular Functioning – A Case Report
Issue: 2022 - Volume 43 [Issue 22]
Soham Samajpaty *
International Faculty, Department of General Medicine, Russian National Research Medical University named after NI Pirogov, Moscow, Russian Federation.
Gulnaz Minegalievna Ibragimova
Department of General Medicine, Russian National Research Medical University named after NI Pirogov, Moscow, Russian Federation.
*Author to whom correspondence should be addressed.
The research gives new therapeutic regimen to Tuberculosis. Despite of the fact being that the current regimen is a burden on liver functioning; most of these are highly hepatotoxic and increases serum alanine aminotransferase (ALT) manifolds. In the backdrop of such a condition this clinical study has been done. Here 4 drugs has been selected and TB infection of a middle aged female patient was cured rapidly in one month who had hepatocellular changes. The regimen in this research has also showed significant improvement of liver functions post-therapy. This is about the “Mumbai Protocol” of tuberculosis management.
Keywords: Tuberculosis, Mycobacterium tuberculosis, Mumbai protocol, infection therapy
How to Cite
Payam Nahid, Susan E. Dorman, Narges Alipanah, Pennan M. Barry, Jan L. Brozek, Adithya Cattamanchi, Lelia H. Chaisson, Richard E. Chaisson, Charles L. Daley, Malgosia Grzemska, Julie M. Higashi, Christine S. Ho, Philip C. Hopewell, Salmaan A. Keshavjee, Christian Lienhardt, Richard Menzies, Cynthia Merrifield, Masahiro Narita, Rick O'Brien, Charles A. Peloquin, Ann Raftery, Jussi Saukkonen, H. Simon Schaaf, Giovanni Sotgiu, Jeffrey R. Starke, Giovanni Battista Migliori, Andrew Vernon, Executive Summary: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis, Clinical Infectious Diseases. 2016;63(7):853–867.
LiverTox: Clinical and research information on drug-induced liver injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Ethambutol. [Updated 2020 Dec 24].
Ramappa V, Aithal GP. Hepatotoxicity related to anti-tuberculosis Drugs: Mechanisms and management. Journal of Clinical and Experimental Hepatology. 2013;3(1):37–49.
Waters M, Tadi P. Streptomycin. [Updated 2022 Jul 11]. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2022.
Liver Tox: Clinical and research information on drug-induced liver injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Streptomycin. [Updated 2021 Sep 15].
LiverTox: Clinical and research information on drug-induced liver injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Cycloserine. [Updated 2017 Nov 3].
Zhang T, Jiang G, Wen S, Huo F, Wang F, Huang H, Pang Y. Para-aminosalicylic acid increases the susceptibility to isoniazid in clinical isolates of Mycobacterium tuberculosis. Infection and Drug Resistance. 2019;12:825–829. Available:https://doi.org/10.2147/IDR.S200697
Zheng J, Rubin EJ, Bifani P, Mathys V, Lim V, Au M, Jang J, Nam J, Dick T, Walker JR, Pethe K, Camacho LR. Para-aminosalicylic acid is a prodrug targeting dihydrofolate reductase in Mycobacterium tuberculosis. The Journal of Biological Chemistry. 2013;288(32):23447–23456.
Hershfield ES. Tuberculosis - Still a major health problem. The Canadian Journal of Infectious Diseases. 1991;2(4):131–132.
Essentials of medical pharmacology. KD Tripathi. 8th edition; Chapter-56, Antitubercular Drugs. 2018:819-820.
Zhao H, Wang Y, Zhang T, Wang Q, Xie W. Drug-induced liver injury from anti-tuberculosis treatment: A retrospective cohort study. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2020;26:e920350. Available:https://doi.org/10.12659/MSM.920350