Management of drug-resistant tuberculosis

Chen Yuan Chiang, H. S. Schaaf

研究成果: 雜誌貢獻文章同行評審

45 引文 斯高帕斯(Scopus)

摘要

Drug-resistant tuberculosis (DR-TB) in adults is either acquired due to poor treatment management or transmitted from infectious DR-TB cases, while children mainly have transmitted disease. Diagnosis of DR-TB relies on drug susceptibility testing (DST), which is not routinely performed in high tuberculosis (TB) burden settings. The Category II retreatment regimen is inadequate for Category I failures if multidrug-resistant TB (MDR-TB) is present. Where possible, DST should be performed for Category I failures and other patients with a high risk of DR-TB. Fluoroquinolones (FQs) should be used with caution in the treatment of mono- and polyresistant TB. Modification of regimens for mono- and polyresistance is prone to error if DST results are not reliable or if there is possible additional drug resistance due to further drug exposure. While standardised treatment is feasible for MDR-TB patients never previously treated with second-line drugs, a different strategy is required for those MDRTB patients who have previously been treated with second-line drugs. Sputum conversion, adverse effects and adherence to MDR-TB treatment should be monitored closely. The presence of FQ resistance prior to MDR-TB treatment poses a serious challenge. To prevent the development of extensively drug-resistant TB, strategies to protect the FQs, the most important second-line agents, need to be developed. Clinical trials assessing MDR-TB treatment regimens are urgently needed.

原文英語
頁(從 - 到)672-682
頁數11
期刊International Journal of Tuberculosis and Lung Disease
14
發行號6
出版狀態已發佈 - 2010
對外發佈

ASJC Scopus subject areas

  • 肺和呼吸系統醫學
  • 傳染性疾病
  • 醫藥 (全部)

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