TY - JOUR
T1 - "Non-antibiotics"
T2 - alternative therapy for the management of MDRTB and MRSA in economically disadvantaged countries
AU - Amaral, L
AU - Viveiros, M
AU - Kristiansen, Jette E.
PY - 2006/7
Y1 - 2006/7
N2 - The antibiotic resistance is now common place throughout the globe. Two highly problematic antibiotic resistant infections are those produced by multi-drug resistant Mycobacterium tuberculosis (MDRTB) and methicillin resistant Staplylococcus aureus (MRSA). Although vancomycin is useful for therapy of MRSA, there is now evidence that resistance to this antibiotic is taking place. Intracellular infections of MRSA are very difficult to manage and are recurrent especially when invasive prosthetic devices are employed. This mini-review provides cogent evidence that both intracellular MDRTB and intracellular MRSA can be killed by concentrations of the non-antibiotic phenothiazine, Thioridazine. at concentrations in the medium that are below those present in the plasma of patients treated with this agent. Although thioridazine has been claimed to cause arrhythmias and even sudden death, the frequencies of these episodes are rare and when present, they are related to the patients underlying cardiac status as opposed to the direct effect of the agent itself. The authors do not suggest that thioridazine be used indiscriminately for MDRTB or intracellular infections produced by MRSA. However, there are circumstances where there are no alternative forms of therapy and the patient faces an unfavourable prognosis. For these highly selective and controlled situations. the use of thioridazine in the manner employed for the therapy of psychosis is recommended (compassionate therapy).
AB - The antibiotic resistance is now common place throughout the globe. Two highly problematic antibiotic resistant infections are those produced by multi-drug resistant Mycobacterium tuberculosis (MDRTB) and methicillin resistant Staplylococcus aureus (MRSA). Although vancomycin is useful for therapy of MRSA, there is now evidence that resistance to this antibiotic is taking place. Intracellular infections of MRSA are very difficult to manage and are recurrent especially when invasive prosthetic devices are employed. This mini-review provides cogent evidence that both intracellular MDRTB and intracellular MRSA can be killed by concentrations of the non-antibiotic phenothiazine, Thioridazine. at concentrations in the medium that are below those present in the plasma of patients treated with this agent. Although thioridazine has been claimed to cause arrhythmias and even sudden death, the frequencies of these episodes are rare and when present, they are related to the patients underlying cardiac status as opposed to the direct effect of the agent itself. The authors do not suggest that thioridazine be used indiscriminately for MDRTB or intracellular infections produced by MRSA. However, there are circumstances where there are no alternative forms of therapy and the patient faces an unfavourable prognosis. For these highly selective and controlled situations. the use of thioridazine in the manner employed for the therapy of psychosis is recommended (compassionate therapy).
KW - RESISTANT MYCOBACTERIUM-TUBERCULOSIS
KW - TORSADE-DE-POINTES
KW - STAPHYLOCOCCUS-AUREUS
KW - IN-VITRO
KW - CLINICAL CONCENTRATIONS
KW - POTENTIAL MANAGEMENT
KW - ANTIPSYCHOTIC-DRUGS
KW - PHENOTHIAZINES
KW - CHLORPROMAZINE
KW - THIORIDAZINE
UR - http://www.scopus.com/inward/record.url?scp=33745738994&partnerID=8YFLogxK
UR - http://www.eurekaselect.com/56303/article
U2 - 10.2174/138945006777709539
DO - 10.2174/138945006777709539
M3 - Review article
C2 - 16842219
SN - 1389-4501
VL - Vol. 7
SP - 887
EP - 891
JO - Current Drug Targets
JF - Current Drug Targets
IS - n.º 7
ER -