Targeted and Controlled Drug Delivery Strategies for Overcoming Limitations of Conventional Tuberculosis Treatment: A Comprehensive Review

Tuberculosis (TB) remains one of the leading infectious diseases worldwide and has been further complicated by multidrug resistance, poor patient compliance and toxicities related to drug regimens. Conventional therapy is based on long-term multi-drug regimens with poor tissue penetration of the granulomatous lesions and often in association with resistance. Various types of carriers such as nanoparticles, liposomes, microspheres, inhaled based carriers are being explored as controlled and targeted drug delivery systems potentially able to circumvent many of these shortcomings by maintaining therapeutic levels while improving site-specific drug activity. Objective: This review provides a general discussion of the development of new targeted and controlled delivery systems for treatment of TB with special emphasis on their significance for overcoming the limitations of conventional therapy. Methodology: A systematic review of the literature was conducted for the time period 2010 to 2025 using PubMed, Scopus and Science Direct. Tropical studies on controlled release formulations, pulmonary carriers, macrophage targeted systems and new nanocarriers were reviewed. Results: Controlled Release platforms increase duration of action, reduce dosing frequency and improve compliance. Targeted delivery reduces systemic toxicity increases alveolar macrophages and granulomatous uptake and increases cure rates. Local bioavailability of pulmonary formulation is better than that of oral forms. Conclusion: Targeted and controlled delivery is a new paradigm for therapy in TB. If they can be successfully translated into clinical practice, they could shorten the duration of therapy, limit the development of drug resistance and maximise benefit from therapy at the global level.