Studies on a new antitubercular drug, trifluoperazine: Its effect in combination with conventional antitubercular drugs in tubercular lymphadenitis

After demonstrating that trifluoperazine (TFP) possesses invitro antitubercular activity against drug (single and multidrug) resistantMycobacterium tuberculosis, we initiated preliminary clinical studies in a few patients of tubercular lymphadenitis. Effect of TFP was assessed by testing the antitubercular activity of the serum of patients receiving TFP in addition to regular therapy. Patients were divided into two groups of 30 each. For ethical considerations, patients of both groups were treated initially for one month with antitubercular therapy (ATT) consisting of isoniazid, rifampicin, ethambutol and pyrazinamide and TFP was tried for 15 days only. Patients of group1 were given a single dose of TFP (5mg/day) daily from days 31 to 45 in addition to ATT, while those in group 2 received ATT only. Assessment of the antitubercular activity of the serum (testedin vitro in Youmans and Karlson’s liquid medium) revealed that the serum of patients (collected on 45th day) of group1 (ATT+TFP treated) possessed much higher antitubercular activity than that of group 2 (ATT only treated) patients. Clinical examination indicated that overall improvement was seen much earlier in group1 (ATT+TFP) patients than in group 2 (ATT alone) patients. At the end of the follow up period of 6 months with ATT from 46th day onwards to both groups, there were no side effects due to TFP. Hematology and liver function tests were normal in both the groups. We suggest that TFP has good potential and therefore deserves further studies either in combination with other drugs of ATT or as one of the drugs of ATT, for the treatment of tuberculosis due to MDR strains to find a suitable effective dose without side effects.