Multi-drug-resistant tuberculosis medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
==Medical Therapy | ==Medical Therapy<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. | ||
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===Drugs Used in Drug-Resistant Tuberculosis=== | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 500px;" align=center | |||
|valign=top| | |||
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Groups}} | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Drugs}} | |||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Group 1: <br> First-line oral drugs | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
* [[Pyrazinamide]] | |||
* [[Ethambutol]] | |||
* [[Rifabutin]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Group 2: <br> Injectable drugs | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Kanamycin]] | |||
*[[Amikacin]] | |||
*[[Capreomycin]] | |||
*[[Streptomycin]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Group 3: Fluoroquinolones | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Levofloxacin]] | |||
*[[Moxifloxacin]] | |||
*[[Ofloxacin]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Group 4: <br> Oral bacteriostatic second-line drugs | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Para-[[aminosalicylic acid]] | |||
*[[Cycloserine]] | |||
*[[Terizidone]] | |||
*[[Ethionamide]] | |||
*[[Protionamide]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Group 5: <br> Agents with unclear role in treatment of drug resistant-TB | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Clofazimine]] | |||
*[[Linezolid]] | |||
*[[Amoxicillin]]/[[clavulanate]] | |||
*[[Thioacetazone]] | |||
*[[Imipenem]]/[[cilastatin]] | |||
*High-dose [[isoniazid]] | |||
*[[Clarithromycin]] | |||
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| style="padding: 5px 5px; background: #F5F5F5;" colspan=2| <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> | |||
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Revision as of 19:46, 25 September 2014
Multi-drug-resistant tuberculosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy 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. Within these 4 drugs must be included at least one drug from each group.
- 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.
- Empirical treatment should start immediately and the regimen should be modified according to the DST (Drug susceptibility testing) results.
- Drugs in each group must be used, in order of preference, as shown below.[2]
- The following treatment regimens show daily dosing for each drug.
▸ Click on the following categories to expand treatment regimens.
MDR Tuberculosis ▸ Adults ▸ Children |
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Drugs Used in Drug-Resistant Tuberculosis
Groups | Drugs |
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Group 1: First-line oral drugs |
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Group 2: Injectable drugs |
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Group 3: Fluoroquinolones | |
Group 4: Oral bacteriostatic second-line drugs |
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Group 5: Agents with unclear role in treatment of drug resistant-TB |
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Adapted from WHO 2013 Treatment of Tuberculosis: Guidelines – 4th ed.[1] |
References
- ↑ 1.0 1.1 1.2 1.3 "2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition)".
- ↑ Caminero, José A; Sotgiu, Giovanni; Zumla, Alimuddin; Migliori, Giovanni Battista (2010). "Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis". The Lancet Infectious Diseases. 10 (9): 621–629. doi:10.1016/S1473-3099(10)70139-0. ISSN 1473-3099.
- ↑ "WHO Guidance for national tuberculosis programmes on the management of tuberculosis in children, 2014" (PDF).