Treatment of Drug-Resistant Tuberculosis: Current Status
Drug-resistant tuberculosis (DR-TB) has been an area of growing concern and posing threat to human health worldwide. The treatment has been defined for all types of DR-TB with or without newer anti-TB drugs. multi-DR-TB (MDR-TB) patients have now choice of two types of regimen, shorter and longer re...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-04-01
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| Series: | Annals of the National Academy of Medical Sciences (India) |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1714201 |
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| author | Rajendra Prasad Harsh Saxena Nikhil Gupta Mohammad Tanzeem Ronal Naorem |
| author_facet | Rajendra Prasad Harsh Saxena Nikhil Gupta Mohammad Tanzeem Ronal Naorem |
| author_sort | Rajendra Prasad |
| collection | DOAJ |
| description | Drug-resistant tuberculosis (DR-TB) has been an area of growing concern and posing threat to human health worldwide. The treatment has been defined for all types of DR-TB with or without newer anti-TB drugs. multi-DR-TB (MDR-TB) patients have now choice of two types of regimen, shorter and longer regimens. Shorter regimen for treatment of subset of MDR-TB patients who have not been previously treated with second line drugs and in whom resistance to fluoroquinolones and second-line injectable agents has been excluded is given for 9 to 11 months. A longer regimen of at least five effective anti-TB drugs (ATDs) during the intensive phase is recommended, including pyrazinamide and four core second-line ATDs. Intensive phase, including injectables, should be given for at least 8 months. The total duration of treatment is at least 20 months, which can be prolonged up to 24 months depending on the response of the patient. World Health Organization (WHO) has recently revised the grouping of ATD for use in DR-TB patients in 2018 into three groups based on individual patient data meta-analysis depending on their individual efficacy, risk of relapse, treatment failure, and death. Recently, an all oral longer regimen comprising bedaquiline, pretomanid, and linezolid (BPal regime) for 6 to 9 months for extensive-DR-TB (XDR-TB) patients and those MDR-TB patients who cannot tolerate or do not respond to conventional MDR-TB regimen. These new developments will be a step forward toward establishing universal regimen to treat all types of DR-TB. This article has summarized the current evidence from literature search to date, including prevalence of DR-TB, types of regimen used and the advancement in the regimens for effective treatment of DR-TB patients. |
| first_indexed | 2024-12-17T03:56:25Z |
| format | Article |
| id | doaj.art-0c6bfaf0a4dd41f5ae04492d2571941b |
| institution | Directory Open Access Journal |
| issn | 0379-038X 2454-5635 |
| language | English |
| last_indexed | 2024-12-17T03:56:25Z |
| publishDate | 2021-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Annals of the National Academy of Medical Sciences (India) |
| spelling | doaj.art-0c6bfaf0a4dd41f5ae04492d2571941b2022-12-21T22:04:36ZengThieme Medical and Scientific Publishers Pvt. Ltd.Annals of the National Academy of Medical Sciences (India)0379-038X2454-56352021-04-01570206807310.1055/s-0040-1714201Treatment of Drug-Resistant Tuberculosis: Current StatusRajendra Prasad0Harsh Saxena1Nikhil Gupta2Mohammad Tanzeem3Ronal Naorem4Department of Pulmonary Medicine, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Pulmonary Medicine, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of General Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, IndiaDepartment of Pulmonary Medicine, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Pulmonary Medicine, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, IndiaDrug-resistant tuberculosis (DR-TB) has been an area of growing concern and posing threat to human health worldwide. The treatment has been defined for all types of DR-TB with or without newer anti-TB drugs. multi-DR-TB (MDR-TB) patients have now choice of two types of regimen, shorter and longer regimens. Shorter regimen for treatment of subset of MDR-TB patients who have not been previously treated with second line drugs and in whom resistance to fluoroquinolones and second-line injectable agents has been excluded is given for 9 to 11 months. A longer regimen of at least five effective anti-TB drugs (ATDs) during the intensive phase is recommended, including pyrazinamide and four core second-line ATDs. Intensive phase, including injectables, should be given for at least 8 months. The total duration of treatment is at least 20 months, which can be prolonged up to 24 months depending on the response of the patient. World Health Organization (WHO) has recently revised the grouping of ATD for use in DR-TB patients in 2018 into three groups based on individual patient data meta-analysis depending on their individual efficacy, risk of relapse, treatment failure, and death. Recently, an all oral longer regimen comprising bedaquiline, pretomanid, and linezolid (BPal regime) for 6 to 9 months for extensive-DR-TB (XDR-TB) patients and those MDR-TB patients who cannot tolerate or do not respond to conventional MDR-TB regimen. These new developments will be a step forward toward establishing universal regimen to treat all types of DR-TB. This article has summarized the current evidence from literature search to date, including prevalence of DR-TB, types of regimen used and the advancement in the regimens for effective treatment of DR-TB patients.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1714201drug-resistant tuberculosisshorter regimenlonger regimen |
| spellingShingle | Rajendra Prasad Harsh Saxena Nikhil Gupta Mohammad Tanzeem Ronal Naorem Treatment of Drug-Resistant Tuberculosis: Current Status Annals of the National Academy of Medical Sciences (India) drug-resistant tuberculosis shorter regimen longer regimen |
| title | Treatment of Drug-Resistant Tuberculosis: Current Status |
| title_full | Treatment of Drug-Resistant Tuberculosis: Current Status |
| title_fullStr | Treatment of Drug-Resistant Tuberculosis: Current Status |
| title_full_unstemmed | Treatment of Drug-Resistant Tuberculosis: Current Status |
| title_short | Treatment of Drug-Resistant Tuberculosis: Current Status |
| title_sort | treatment of drug resistant tuberculosis current status |
| topic | drug-resistant tuberculosis shorter regimen longer regimen |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1714201 |
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