Drug-resistant tuberculosis medical therapy: Difference between revisions

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Revision as of 15:27, 17 September 2014

Tuberculosis Microchapters

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Risk calculators and risk factors for Drug-resistant tuberculosis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

Multiple Drug-Resistant (MDR) Tuberculosis

  • MDR-TB is defined as resistance to isoniazid and rifampicin, with or without resistance to other first-line drugs.
  • Medical treatment for MDR-TB consists of at least 4 drugs that have shown effectiveness against MDR.
  • Treatment duration will depend on the culture results. The duration of therapy should be > 18 months after culture is negative.

MDR Tuberculosis

  ▸  Adults

  ▸  Children

MDR-TB Adults
Standard Regimen
Group 1: First-line oral drugs

Pyrazinamide
OR
Ethambutol
OR
Rifabutin

PLUS
Group 2: Injectable drugs

Kanamycin
OR
Amikacin
OR
Capreomycin
OR
Streptomycin

PLUS
Group 3: Fluoroquinolones

Levofloxacin
OR
Moxifloxacin
OR
Ofloxacin

PLUS
Group 4:Oral bacteriostatic second-line drugs

Para-aminosalicylic acid
OR
Cycloserine
OR
Terizidone
OR
Ethionamide
OR
Protionamide

MDR-TB Children
Preferred Regimen

Extensively Drug-Resistant XDR Tuberculosis

XDR-TB is defined as resistance to at least isoniazid and rifampicin, and to any fluoroquinolone, and to any of the three second-line injectables (amikacin, capreomycin, and kanamycin).

XDR Tuberculosis

  ▸  Adults

  ▸  Children

XDR-TB Adults
Preferred Regimen
▸ '
XDR-TB Children
Preferred Regimen

Extremely Drug-Resistant (XXDR) Tuberculosis

References