Posts Tagged ‘treatment of xdr tb’

the world’s oldest (and newest) treatment for tuberculosis

It’s a quiet Saturday afternoon in Mexicali, so I am trying to catch up on my reading for the week – on all the topics covered last week, as well as in anticipation of our upcoming cases this week.. Too bad Pubmed makes it so easy to get side-tracked at times.. (Bet you can hear me whine: But – it was just so interesting – I had to stop and read this completely un-related article… (In addition to the 27 other articles that are actually germane to the thoracic surgery topics.)  But – (as I rationalize to myself), with tuberculosis exploding across the globe – especially here in Mexico – isn’t it important to explore all avenues/ possibilities?  Yeah – that argument is pretty weak, but that’s the one I am going with – or at least just long enough to read (and mention) the articles..

So here’s today’s diversion:  three articles on the use of garlic to treat tuberculosis – including drug resistant tuberculosis.  (And no – it doesn’t work by scaring people out of droplet range – it works through the anti-bacterial properties of the herb itself.)  While the medicinal properties of garlic have been long touted for many diseases and conditions such as heart disease, hypertension, vaginal candida etc – the authors listed below (along with others) are investigating the use of garlic (crushed) as a treatment of active TB infection.

Dini C, Fabbri A, Geraci A. (2011).  The potential role of garlic (Allium sativum) against the multi-drug resistant tuberculosis pandemic: a review. Ann Ist Super Sanita. 2011;47(4):465-73. Review of existing literature.

The Italian authors review the pandemic of TB particularly in the setting of sub-saharan African miners (with confounding HIV and silicosis) as part of their illustration of the scope of the problem.   I consider this article to be the best of the bunch – as it explores not only the long history of the medicinal uses of garlic – but how garlic may be our most cost-effective, least toxic, and most widely accepted option by our patients.

Gupta R, Thakur B, Singh P, Singh HB, Sharma VD, Katoch VM, Chauhan SV. (2010). Anti-tuberculosis activity of selected medicinal plants against multi-drug resistant Mycobacterium tuberculosis isolates.  Indian J Med Res. 2010 Jun;131:809-13.

acalypha indica (Indian nettle)

This Indian article looks at extracts from five different plants to examine their anti-tubercular activity (anti-mycobacterial).  I’ve looked up all of the plants for you – (aloe vera not so difficult – but how many of us knew (off hand) that acalypha indica is an Indian nettle?  The other four include adhatoda vasica (malabar nut tree) which is a common ingredient in Indian cough syrups, aloe vera (our old friend and sunburn soother), alium cepa (which is your garden variety onion), and allium sativum (garlic).

adhatoda vasica (malabar nut tree)

Unfortunately, this study is more about chemists in a lab – than actual treatments for a patient, so most of the findings are of limited use – except that our new friend, adhatoda vasica didn’t fare so well – but our old friend (and date destroyer), allium sativum did just great..

The last article in our line-up is a bit of a reminder – that a lot of important observations can get buried in the sheer volume of data, research and other publications that come out every year.. This article was first published in 1985.

Delaha EC, Garagusi VF (1985). Inhibition of mycobacteria by garlic extract (Allium sativum). Antimicrob Agents Chemother. 1985 Apr;27(4):485-6.  This study comes from the microbiology labs at Georgetown.  It’s short and to the point, with the authors providing a clear and concise description of how the garlic was prepared – to create the allicin compound (unhandled/ raw garlic contains the precursor.)  Luckily – this compound is activated by crushing the garlic – kind of like squeezing or breaking a glow stick..
Of course  – all this reading, along with my original (non-garlic) articles just reminds me how sheltered/ lucky I’ve been in my rural US practice – to see TB cases only few and far between, and in a very limited sort of way.  I mean – I’ve followed all the news about the ‘resurgence of TB’ – who hasn’t?  But unlike many of my colleagues in larger cities – even though I know it’s out there – we just hadn’t really seen much TB (as a surgical disease) in our area..

Since I’ve been here I’ve seen several cases daily – the majority in patients under the age of 25 – with gross hemopytsis, empyemas, and destroyed lung.  I think for American providers the last two generations have made us forget the devastation this disease causes.  Our grandfathers remember this disease – and the rest of us need to catch up.  The white plague is back*.

* For much of the rest of the world – it never really went away.


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