Mycobacterium tuberculosis Treatment Modalities and Recent Insights
V. Sukhithasri, Vivek Vinod, Sarath Varma and Raja Biswas
Affiliation: Amrita Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, AIMS-Ponekkara, Cochin, PIN: 682041, India.
Keywords: Antibiotics, cytokines, intracellular pathogen, immune response, macrophages, nanoparticles, tuberculosis.
Antimicrobial therapy of infections caused by M. tuberculosis is a challenge due to poor response to therapy
and recurrent infections. Under in vitro conditions, antibiotics effectively kill M. tuberculosis within the first two weeks.
However, an extended treatment time of 6-9 months is required to eradicate M. tuberculosis infection, mainly due to the
intracellular survival of this pathogen and poor penetration of the antibiotics into the intracellular compartment of the host
cells. Recent advances in the field of drug delivery have led to the use of different antibiotic incorporated nano- and micro-
formulations such as liposomes, polymeric particles, mesoporous silica particles and particulate suspensions for targeted
drug delivery applications into the intracellular compartment of the macrophages. The drug incorporated nano- and
micro-particles are prone to be easily internalized, which leads to preferential delivery of the drugs into the tissues and organs
of interest. Other advantages of these nano- and micro-particles over the free drugs are their comparatively higher
stability and bioavailability. This review highlights the current strategies and challenges in treatment, the different antibiotics
available, their modes of action, generation and mechanism of drug resistance and recent advances in the intracellular
drug delivery using nanoparticles for the treatment of tuberculosis.
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