Multi-drug-resistant TB (MDR-TB) is defined as resistance to both isoniazid and rifampicin, with or without resistance to any other antituberculosis drugs.
Resistance to multiple first-line antitubercular drugs should be should be suspected if disease activity does not show signs of subsiding after 4-6 months of uninterrupted multidrug therapy.
Treatment of multidrug resistance needs many questioned t be answered.Many crucial management issues in MDR-TB treatment remain unanswered and the existing primary literature on the issue is not enough.
There are no standardized regimens or guidelines.
Second-line and potential antitubercular drugs will have to be tried.
If reliable laboratory facilities are available, drug susceptibility should be determined and treatment commenced with relevant second-line or experimental drugs.
It has been suggested that four or five (at least three) antitubercular drugs, including the fluoroquinolones, must be included in the regimen and that, if needed, these drugs should be changed at the same time, not one by one.
Further, treatment with these drugs takes 2 years or longer, as opposed to 6 to 9 months with isoniazid-ri-fampicin-containing regimens.
In general, second-line drugs are more expensive and toxic and treatment, at least in the initial part, should therefore be supervised in a hospital.
Immunomodulatory therapy with levamisole and Mycobacterium vaccae have failed to produce the desired results. Other immunomodulators, such as recombinant human interleukin- 2 and recombinant interferon-alpha2b, are being tried.
Popularity: 2% [?]
Related posts:
- Anyplex MDR-TB Test – New Test For Detection Of Multidrug Resistance Tuberculosis Developed
- Treatment Of Osteoarticular Tuberculosis In Patients With HIV
- Duration of chemotherapy In Osteoarticular Tuberculosis
- Musculoskeletal Tuberculosis – General Principles of Management
- Clinical Photograph of Tuberculosis of Sternoclavicular Joint
Join Discussions