title: Tuberculosis chemotherapy: current drug delivery approaches.
abstract: Tuberculosis is a leading killer of young adults worldwide and the global scourge of multi-drug resistant tuberculosis is reaching epidemic proportions. It is endemic in most developing countries and resurgent in developed and developing countries with high rates of human immunodeficiency virus infection. This article reviews the current situation in terms of drug delivery approaches for tuberculosis chemotherapy. A number of novel implant-, microparticulate-, and various other carrier-based drug delivery systems incorporating the principal anti-tuberculosis agents have been fabricated that either target the site of tuberculosis infection or reduce the dosing frequency with the aim of improving patient outcomes. These developments in drug delivery represent attractive options with significant merit, however, there is a requisite to manufacture an oral system, which directly addresses issues of unacceptable rifampicin bioavailability in fixed-dose combinations. This is fostered by the need to deliver medications to patients more efficiently and with fewer side effects, especially in developing countries. The fabrication of a polymeric once-daily oral multiparticulate fixed-dose combination of the principal anti-tuberculosis drugs, which attains segregated delivery of rifampicin and isoniazid for improved rifampicin bioavailability, could be a step in the right direction in addressing issues of treatment failure due to patient non-compliance.
authors.affiliation: University of the Witwatersrand, Faculty of Health Sciences, Department of Pharmacy and Pharmacology, 7 York Road, Parktown, 2193, South Africa. lisad@worldonline.co.za
authors.forename: Lisa Claire
authors.initials: LC
authors.lastname: du Toit
authors.forename: Viness
authors.initials: V
authors.lastname: Pillay
authors.forename: Michael Paul
authors.initials: MP
authors.lastname: Danckwerts
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D016503:Drug Delivery Systems / Q000379:methods*; D006801:Humans; D014376:Tuberculosis / Q000188:drug therapy* / Q000378:metabolism; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000378:metabolism
chemical_list: D000995:Antitubercular Agents