Drug-resistant tuberculosis medical therapy: Difference between revisions
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==Multiple Drug-Resistant (MDR) Tuberculosis== | ==Multiple Drug-Resistant (MDR) Tuberculosis<small><small><small> Adapted from WHO 2013 Treatment of tuberculosis: guidelines – 4th ed. <ref name="WHO 2013"> {{cite web| url=http://www.who.int/tb/publications/tb_treatmentguidelines/en/| title=2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition) }}</ref></small></small></small> | ||
*MDR-TB is defined as resistance to isoniazid and rifampicin, with or without resistance to other first-line drugs. | |||
*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. | *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. | *Treatment duration will depend on the culture results. The duration of therapy should be > 18 months after culture is negative. | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 1: First-line oral drugs</u>''' <br> | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 1: First-line oral drugs</u>''' <br> | ||
▸ ''' Pyrazinamide''' <br> OR <br> ▸ '''Ethambutol ''' <br> OR <br> ▸ '''Rifabutin''' | ▸ ''' [[Pyrazinamide]]''' <br> OR <br> ▸ '''[[Ethambutol]] ''' <br> OR <br> ▸ '''[[Rifabutin]]''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 2: Injectable drugs</u>''' <br> | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 2: Injectable drugs</u>''' <br> | ||
▸ '''Kanamycin'''<br> OR <br> ▸ '''Amikacin'''<br> OR <br> ▸ '''Capreomycin'''<br> OR <br> ▸ '''Streptomycin''' | ▸ '''[[Kanamycin]]'''<br> OR <br> ▸ '''[[Amikacin]]'''<br> OR <br> ▸ '''[[Capreomycin]]'''<br> OR <br> ▸ '''[[Streptomycin]]''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 3: Fluoroquinolones</u>''' <br> | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 3: Fluoroquinolones</u>''' <br> | ||
▸ '''Levofloxacin'''<br> OR <br> ▸ '''Moxifloxacin'''<br> OR <br> ▸ '''Ofloxacin''' | ▸ '''[[Levofloxacin]]'''<br> OR <br> ▸ '''[[Moxifloxacin]]'''<br> OR <br> ▸ '''[[Ofloxacin]]''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 4:Oral bacteriostatic second-line drugs</u>''' <br> | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 4:Oral bacteriostatic second-line drugs</u>''' <br> | ||
▸ '''Para-aminosalicylic acid'''<br> OR <br> ▸ '''Cycloserine'''<br> OR <br> ▸ '''Terizidone'''<br> OR <br> ▸ '''Ethionamide'''<br> OR <br> ▸ '''Protionamide''' | ▸ '''[[Para-aminosalicylic acid]]'''<br> OR <br> ▸ '''[[Cycloserine]]'''<br> OR <br> ▸ '''[[Terizidone]]'''<br> OR <br> ▸ '''[[Ethionamide]]'''<br> OR <br> ▸ '''[[Protionamide]]''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left |<small>Table adapted from WHO 2013 Treatment of tuberculosis: guidelines – 4th ed.<ref name="WHO 2013"> {{cite web| url=http://www.who.int/tb/publications/tb_treatmentguidelines/en/| title=2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition) }}</ref></small> | | style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left |<small>Table adapted from WHO 2013 Treatment of tuberculosis: guidelines – 4th ed.<ref name="WHO 2013"> {{cite web| url=http://www.who.int/tb/publications/tb_treatmentguidelines/en/| title=2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition) }}</ref></small> | ||
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|MDR-TB Children}} | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|MDR-TB Children}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | ''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Standard Regimen''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 1: First-line oral drugs</u>''' <br> | |||
▸ ''' [[Pyrazinamide]]''' <br> OR <br> ▸ '''[[Ethambutol]] ''' <br> OR <br> ▸ '''[[Rifabutin]]''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 2: Injectable drugs</u>''' <br> | |||
▸ '''[[Kanamycin]]'''<br> OR <br> ▸ '''[[Amikacin]]'''<br> OR <br> ▸ '''[[Capreomycin]]'''<br> OR <br> ▸ '''[[Streptomycin]]''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | |||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 3: Fluoroquinolones</u>''' <br> | ||
▸ '''[[Levofloxacin]]'''<br> OR <br> ▸ '''[[Moxifloxacin]]'''<br> OR <br> ▸ '''[[Ofloxacin]]''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''<u>Group 4:Oral bacteriostatic second-line drugs</u>''' <br> | |||
▸ '''[[Para-aminosalicylic acid]]'''<br> OR <br> ▸ '''[[Cycloserine]]'''<br> OR <br> ▸ '''[[Terizidone]]'''<br> OR <br> ▸ '''[[Ethionamide]]'''<br> OR <br> ▸ '''[[Protionamide]]''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left |<small>Table adapted from WHO 2013 Treatment of tuberculosis: guidelines – 4th ed.<ref name="WHO 2013"> {{cite web| url=http://www.who.int/tb/publications/tb_treatmentguidelines/en/| title=2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition) }}</ref></small> | |||
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Revision as of 15:51, 17 September 2014
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Tuberculosis Microchapters |
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Drug-resistant tuberculosis medical therapy On the Web |
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American Roentgen Ray Society Images of Drug-resistant tuberculosis medical therapy |
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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 Adapted from WHO 2013 Treatment of tuberculosis: guidelines – 4th ed. [1]
- 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.
- Chronic cases with severe pulmonary disease may require more than 24 months of therapy.
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MDR Tuberculosis ▸ Adults ▸ Children |
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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).
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XDR Tuberculosis ▸ Adults ▸ Children |
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