We have shown that thioridazine promotes the killing of MDR and XDR Mtb by non-killing human macrophages and have also demonstrated the mechanism of action.
I have faced with patients with XDR-PTB. I would like to know what is the best regimen to treat these patients?.What is your opinion?
Firstly, we petition the ethics bd of the hospital to treat the patient under "compassionate basis" given that nothing that has been made available has worked. Then, we evaluate the pt for cardiac function since the thioridazine may increase the QT interval. Dose of thioridazine begun at 25 mg/day for first week, then increase to 59, and eventually to 200 mg/day while monitoring cardiac function. Under these conditions no effect on cardiac funtion has been noted. Periodically, do acid fast and culture. Remarkably, acid fast negative result after a few weeks; negative culture a bit longer. Evaluate pt clincially, etc. Suggest Abbate E et al, JAC 2012 paper serve as guidelines.
Please let me know of your intentions,
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