Multidrug resistant tuberculosis treatment in India

Abstract

Multidrug-resistant tuberculosis (MDR-TB) is posing a major public health threat as well as a big challenge to global efforts of tuberculosis control. The management of MDR-TB patients is difficult, expensive, challenging and quite often leads to treatment failure. To avoid further transmission, a comprehensive approach for rapid detection, proper treatment and effective public health measures must be ensured. It must also be emphasized that even optimal treatment of MDR-TB will not alone curb the epidemic. Efforts must be focused on the effective use of first-line drugs in every new case so as to prevent the ultimate emergence of MDR-TB.

Recent and New Strategies for Extensively-Drug Resistant Tuberculosis

“…New MDR-TB treatment regimens are required to have oral delivery, a good side-effect profile, shorter duration regimens, and minimal interaction with antiretrovirals [15] . [16] . This regimen is very convenient for high TBprevalent and low-income countries.…”

“…Standardized second-line treatment has been shown to be applicable and cost-effective in MDR-TB [16,17] .…”

“…Linezolid (LZD), fluoroquinolones, clofazimine, and meropenemclavulanate are considered for the treatment of drug-resistant TB in general [16,22] .…”

“…In a double-blind, placebo-controlled trial, pulmonary MDR-TB subjects were given metronidazole (500 mg three times daily) or placebo for eight weeks in addition to a background regimen [16] .…”

“…Overall, 81% showed clinical success six months after stopping therapy, with no differences. Newer nitroimidazoles may increase the sterilizing potency of future treatment regimens [16,17,37] .…”