title: Potential therapy of multidrug-resistant and extremely drug-resistant tuberculosis with thioridazine.
abstract: Multidrug-resistant tuberculosis (MDRTB) infections that continue to increase in frequency globally have progressed to become extremely drug-resistant tuberculosis (XDRTB). The therapeutic problems associated with MDRTB pale in comparison to those for XDRTB where mortality is high. This mini-review highlights the evidence that supports the use of the phenothiazine neuroleptic thioridazine for the therapy of XDRTB. Although thioridazine does produce some serious side-effects, the poor prognosis associated with an XDRTB infection of a patient that presents with AIDS merits that the use of thioridazine for therapy of XDRTB is seriously considered. A recommended protocol is presented.
authors.affiliation: Group of Mycobacteriology, Unit of Medical Microbiology, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisbon, Portugal. lamaral@ihmt.unl.pt
authors.forename: Leonard
authors.initials: L
authors.lastname: Amaral
authors.forename: Joseph
authors.initials: J
authors.lastname: Molnar
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality; D000995:Antitubercular Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000037:antagonists & inhibitors; D001682:Biological Availability; D002118:Calcium / Q000378:metabolism; D057176:Compassionate Use Trials; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy* / Q000401:mortality; D006331:Heart Diseases / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D017136:Ion Transport / Q000187:drug effects; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology / Q000517:prevention & control; D010588:Phagosomes / Q000201:enzymology / Q000382:microbiology; D011188:Potassium / Q000378:metabolism; D011379:Prognosis; D011485:Protein Binding / Q000187:drug effects; D016879:Salvage Therapy; D013881:Thioridazine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; D013881:Thioridazine; D011188:Potassium; D002118:Calcium