|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 1 | Page : 30
β-lactams against tuberculosis
Milind Davane, Basavraj S Nagoba
Department of Microbiology, MIMSR Medical College, Latur, Maharashtra, India
|Date of Web Publication||31-Mar-2017|
Basavraj S Nagoba
Department of Microbiology, MIMSR Medical College, Latur - 413 531, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Davane M, Nagoba BS. β-lactams against tuberculosis. J Patient Saf Infect Control 2016;4:30
We read with great interest an article entitled, “β-Lactams against Tuberculosis (TB) - New Trick for an Old Dog?” by Diacon et al. published in New England J Med. We would like to add the followings with respect to use of β-lactams against TB.In vitro susceptibility data show that Mycobacterium tuberculosis is intrinsically resistant to β-lactams. It is because of either β-lactamases inactivating these drugs  or lipid-rich outer cell wall that is believed to be a virtually impermeable barrier to these drugs.,
The present report shows reduction in bacterial load in sputum after giving meropenem and amoxycillin-clavulanic acid in 15 patients. Successful treatment of multidrug-resistant TB with regimen including amoxycillin-clavulanic acid has also been reported. These reports are anecdotal and do not justify overall efficacy of β-lactams. No single study has shown clear evidence of effect of β-lactams against M. tuberculosis in vivo although some β-lactams are active in-vitro.
Although some β-lactam antibiotics are active in vitro against M. tuberculosis, there is limited evidence of in vivo bactericidal activity. Although they are safe, their efficacy remains unclear.
Although amoxycillin-clavulanic acid has been included as third-line drug with unclear efficacy for the treatment of TB by the World Health Organization, this drug is not registered and recommended for routine use making its use off-label. It seems to yield no successful results. In view of clinical evidence, the use of β-lactams for TB is not justifiable by considering anecdotal reports. We really want a new trick for this old dog.
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Conflicts of interest
There are no conflicts of interest.
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