A Review on Current Trends of Anti-Tubercular Drugs and Challenges in Eliminating Tuberculosis

Tuberculosis (TB) is a communicable disease that is a major cause of ill health and a threat to health worldwide. Tuberculosis accounts for one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent which is M. tuberculosis (ranking above HIV/AIDS). If the patients are diagnosed on time and treated with first-line antibiotics for 6 months, most people who develop TB could be cured and onward transmission of infection could be reduced. Sustainable Development Goals Target 3.3 includes eliminating the TB epidemic by 2030. The End TB Strategy explains milestones (for 2025) and targets (for 2030 and 2035) for depletion in TB cases and deaths, 90% reduction in the number of TB deaths, and an 80% reduction in the TB prevalence rate compared with levels in 2015 are the targets for 2030. Evolution of Tuberculosis as Drug-resistant TB continues to be a public health threat. About half a million new cases of rifampicin-resistant TB (of which 78% had Multi-Drug-Resistant TB) were reported in 2018. India (27%), China (14%), and the Russian Federation (9%) bear the largest share of the global burden of TB patients. Diagnosis of MDR/RR-TB needs bacteriological confirmation of TB and testing for drug resistance using rapid molecular tests, sequencing technologies, or culture methods. Treatment requires a course of second-line drugs for at least 9 months and up to 20 months, held by counseling and monitoring for adverse events. Newer agents like Bedaquiline, Delamanid, Linezolid may be the key for the further treatment of MDR and XDR-TB although they are required to prove their safety in the treatment through proper monitoring and evaluations. The DUE study of TB medications helps in monitoring, evaluating, and make necessary modifications to the prescribing habits to achieve rational and cost-effective treatment. Although there are many challenges to tackle in front of the world if this has to be eliminated then the whole world has to come together and put its efforts towards ending it.