Tuberculosis clofazimine

Clofazimine has some activity against M. tuberculosis and is used as a last resort drug for the treatment of MDR tuberculosis. It is primarily used in the treatment of M. leprae and M. avium-intracellulare. Further details are discussed later, under the treatment of leprosy. 

Clofazimine is given to treat sulfone-resistant leprosy or to patients who are intolerant to sulfones. It also exerts an antiinflammatory effect and prevents erythema nodosum leprosum, which can interrupt treatment with dapsone. This is a major advantage of clofazimine over other antileprosy drugs. Ulcerative lesions caused by Mycobacterium ulcerans respond well to clofazimine. It also has some activity against M. tuberculosis and can be used as last resort therapy for the treatment of MDR tuberculosis. 

Unfortunately, MAC is resistant to the standard drugs used for tuberculosis, such as isoniazid and pyrazinamide. Multiple agents such as rifampin, rifabutin (ansamycin), clofazimine, imipenem, amikacin, ethambutol, ciprofloxacin, clarithromycin, and azithromycin have varying degrees of in vitro anti-MAC activity. Controversy formerly existed as to whether treatment for MAC is beneficial, but data indicate that an aggressive therapeutic approach decreases symptoms... 

M. tuberculosis Isoniazid -1- rifampin - -pyrazinamide -1- ethambutol or streptomycin Moxifloxacin or gatifloxacin cycloserine capreomycin kanamycin amikacin ethionamide clofazimine aminosalicylic acid... 

The second-line drugs for tuberculosis are found to be more toxic but may be required with certain resistance problems. These drugs essentially include fluroquinolones (e.g., ofloxacin, ciprofloxacin), cycloserine, ethionosamide, aminosalicylic acid, aminoglycosides (viz., amikacin, kanamycin), clofazimine, and capreomycin. 

Mycobacterium tuberculosis (extensively drug-resistant) Lung Drug combinations (strepto-mycin/isonicotinyl/ hydrazine/rifampin/ ethambutol/pyrazinamide/ moxifloxacine/cycloser-ine/imipenem/co-amoxi-clav/clofazimine/ prochlorperazine/ metronidazole), PA-824 and R207910... 

Xu HB, Jiang RH, Xiao HP. Clofazimine in the treatment of multidrug-iesistant tuberculosis. Clin Microbiol Infect 2012 18(ll) 1104r-10. 

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