The challenge of the new tuberculosis drugs Simon Tiberi 1,9 , Ruaridh Buchanan 1,9 , José A. Caminero 2,3 , Rosella Centis 4 , Marcos Abdo Arbex 5 , Miguel Salazar 6 , Jessica Potter 7,8 , Giovanni Battista Migliori 4 1. Barts Health NHS Trust, Royal London Hospital, Division of Infection, 80 Newark Street, E1 2ES London, United Kingdom 2. University Hospital of Gran Canaria "Dr Negrin'', Pneumology Department, Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Las Palmas, Spain 3. International Union against Tuberculosis and Lung Disease, Paris, France 4. Maugeri Care and Research Institute, IRCCS, World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Tradate, Italy 5. University Center of Araraquara Hospital Nestor Goulart Reis, São Paulo State Secretary of Health, São Paulo, Brazil 6. Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico 7. Barts Health NHS Trust, Royal London Hospital, Department of Respiratory Medicine, 80, Newark Street, E1 2ES London, United Kingdom 8. Blizard Institute, Barts and the London School of Medicine and Dentistry, Centre for Primary Care and Public Health, E1 2AB London, United Kingdom Correspondance : Giovanni Battista Migliori, Maugeri Care and Research Institute, IRCCS, World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Tradate, Italy. giovannibattista.migliori@icsmaugeri.it Summary Tuberculosis (TB) continues to cause more deaths worldwide than any other single infectious disease. Even though tuberculosis appears to be decreasing in incidence globally for some time, the proportion of drug resistance is increasing, contributing to greater complexity, morbidity and mortality as well as cost. Since the advent of rifampicin in the 1960s, and the implementation of standard quadruple anti-tuberculosis regimen in the late 1970s, no new drugs have been changed the rst line regimen. This regimen is effective however it is pill burden, and duration has not received investment and innovation. Drug-resistant regimens are long and frequently poorly tolerated due to signicant toxicity. This review is an update on what is new in the treatment of drug-susceptible and drug-resistant tuberculosis, new TB drugs currently being used and studied in clinical trials are also mentioned. Fortunately, there have been many signicant advances in this eld in recent years. The horizon is changing with the new WHO shorter multidrug-resistant tuberculosis regimens and with the increasing availability of new or repurposed drugs like bedaquiline, delamanid, clofazimine and linezolid. These drugs pose new challenges relating to their rational use to prevent selection of resistant strains of Mycobacterium tuberculosis even before a new regimen has been studied. The availability of these new drugs is offering hope and new possibilities for saving patients who had few or no treatment options. Their use and combination into effective regimens need to be studied; trials are in progress. It is hoped that soon we will be able to treat sensitive and drug-resistant cases with a universal regimen, this would revolutionise treatment and take us another step closer towards elimination. Disponible sur internet le : 28 février 2017 9 Tiberi and Buchanan only contributed equally. In this issue Editorial Breaking the barriers: Migrants and tuberculosis. G. Sotgiu (Italy) et al. Tuberculosis elimination and the challenge of latent tuberculosis. A. Matteelli (Italy) et al. The cursed duet today: Tuberculosis and HIV- coinfection. S. Tiberi (UK) et al. The challenge of the new tuberculosis drugs. S. Tiberi (UK) et al. Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis. R. R. Nathavitharana (USA) et al. tome 46 > n82 > mars 2017 http://dx.doi.org/10.1016/j.lpm.2017.01.016 © 2017 Elsevier Masson SAS. Tous droits réservés. e41 Presse Med. 2017; 46: e41e51 on line on www.em-consulte.com/revue/lpm www.sciencedirect.com TUBERCULOSIS Quarterly Medical Review © 2021 Elsevier Masson SAS. Tous droits réservés. - Document téléchargé le 05/12/2021 Il est interdit et illégal de diffuser ce document.