Re: "Turning back the tuberculosis tide."1 My group has published a number of studies and reviews that provide evidence that phenothiazines have activity against all strains of Mycobacterium tuberculosis regardless of their antibiotic susceptibitility status.23 We have shown over the past 15 years that although phenothiazines have in vitro activity against tuberculosis (TB), the concentrations needed are in the order of 20 ug/ml and the maximum concentration that can be achieved in a human is less than 0.5 ug/ml. Because TB is an intracellular infection, any drug must work against intracellular TB, and, more importantly, intra-cellular multidrug-resistant tuberculosis. We have demonstrated that this is the case at phenoziathine concentrations as low as 0.1 ug/ml.4 We are therefore heartened that the TB Alliance is interested in the potential use of phenothiazines for TB.

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