Paolo Antonio ASCIERTO
From a historical point of view, treatment of neoplastic disease can be considered one of the clearest example of the importance of combination strategies. In fact, a combination of surgery, radiotherapy and chemotherapy, is the best approach for the treatment of certain cancers such as breast cancer, ovarian and head and neck cancer. However, not only cancer may benefit from combination therapy. Tubercolosis is a classical example of this concept [1]. After the discovery of Streptomycin in 1944, a new era for the treatment of tubercolosis dawned with further detection of Isoniazid, the first oral mycobactericidal drug in 1952 and Rifamycins in 1957. Sanatoria closed and truly effective public health measures became possible. Treatment was also increasingly expanded to include those with latent tuberculous infections. Furthermore, the introduction of Rifampicin in 1970 revolutionized the treatment of tuberculosis as, with its use in the context of combination strategies, the therapy of this infectious disease changed. In fact, use of antituberculosis drugs in monotherapy, including those of first choice, is strictly proscribed, since it might be easy to select spontaneously resistant germs. For this reason, drug regimens include associations of 3 or more drugs, variously alternated in relation to the clinical and developmental stages of tuberculosis (Table 1). Another aim of using drugs in combination was to eliminate bacterial subpopulations in various stages of metabolic activity and at different locations.
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