Oral anti-tuberculosis drugs: An urgent medication reconciliation at hospitals in Indonesia

Breaking barriers: The potential of nanosystems in antituberculosis therapy

Tuberculosis (TB), caused by Mycobacterium tuberculosis, continues to pose a significant threat to global health. The resilience of TB is amplified by a myriad of physical, biological, and biopharmaceutical barriers that challenge conventional therapeutic approaches. This review navigates the intricate landscape of TB treatment, from the stealth of latent infections and the strength of granuloma formations to the daunting specters of drug resistance and altered gene expression. Amidst these challenges, traditional therapies often fail, contending with inconsistent bioavailability, prolonged treatment regimens, and socioeconomic burdens. Nanoscale Drug Delivery Systems (NDDSs) emerge as a promising beacon, ready to overcome these barriers, offering better drug targeting and improved patient adherence. Through a critical approach, we evaluate a spectrum of nanosystems and their efficacy against MTB both in vitro and in vivo. This review advocates for the intensification of research in NDDSs, heralding their potential to reshape the contours of global TB treatment strategies.

Hemorrhagic pleural effusion in Indonesian male with pulmonary tuberculosis: A rare case

Background

Patients with hemorrhagic pleural effusion who live in tuberculosis endemic areas are recommended to perform adenosine deaminase (ADA) test.

Case presentation

A Javanese 22-year-old male complained of shortness of breath and cough with phlegm for 1 week, and worsened 3 days before being admitted to the hospital. The X-ray results showed pleural effusion, and hemorrhagic pleural effusion examination showed an increase in lymphocytes (60.2%), lactate dehydrogenase/LDH (2624 U/L), and cell count (4584 cells/mm³), and the ADA test obtained 49 IU/L. The water-sealed drainage (WSD) was installed and first-line anti-tuberculosis drug (ATD) was given for 1 month. After showing improvement in the first month, the first-line ATD was continued until 6 months.

Discussion

Patients with hemorrhage pleural effusion who live in tuberculosis endemic areas are recommended to perform differential diagnosis of hemorrhage pleural effusion and pulmonary tuberculosis. The use of the first-line ATD in hemorrhagic pleural effusion and pulmonary tuberculosis needs to be evaluated in the first month to detect improvement, otherwise, the medication is stopped and other investigations are carried out.

Conclusion

Successful management of hemorrhagic pleural effusion and pulmonary tuberculosis depends on early diagnosis.

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The diagnosis of tuberculosis pleural effusion is considered in endemic tuberculosis.

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Management of hemorrhagic tuberculosis pleural effusion includes chest tube and anti-tuberculosis drug (ATD).

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Hemorrhagic tuberculosis pleural effusion can be confirmed by the ADA test.