New antibacterial drugs for the treatment of mycobacterial disease in man

New chemotherapeutic drugs are needed for the treatment of mycobacterial infections to expand the number of available drugs in the face of increasing drug-resistance, to shorten the period of treatment, to allow effective treatment of Mycobacterium avium-intracellulare-scrofulaceum (MAIS) complex infections and, of greatest importance for tuberculosis, to facilitate fully supervised, widely intermittent regimes. Several new rifamycin derivatives are being explored and appear likely to achieve many of these aims. The fluorinated quinolones are the most promising new drugs for the treatment of leprosy. However, the most active quinolones are only just effective in tuberculosis at current dose levels. The β-lactam group and inhibitors of dihydrofolate reductase are only at the stage of in vitro study