Medical Treatment of Pulmonary Multidrug-Resistant Tuberculosis.
- Author:
Tae Sun SHIM
1
;
Kyung Wook JO
Author Information
- Publication Type:Review
- Keywords: Tuberculosis; Multidrug-resistant; Therapeutics; Extensively drug-resistant tuberculosis
- MeSH: Clofazimine; Cycloserine; Drug Resistance; Extensively Drug-Resistant Tuberculosis; Fluoroquinolones; Kanamycin; Levofloxacin; Linezolid; Prothionamide; Pyrazinamide; Tuberculosis; Tuberculosis, Multidrug-Resistant*; World Health Organization
- From:Infection and Chemotherapy 2013;45(4):367-374
- CountryRepublic of Korea
- Language:English
- Abstract: Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging because of the high toxicity of second-line drugs and the longer treatment duration required compared with drug-susceptible TB. The efficacy of treatment for MDR-TB is poorer than that for drug-susceptible TB. The selection of drugs in MDR-TB is based on previous treatment history, drug susceptibility results, and TB drug resistance patterns in the each region. Recent World Health Organization guidelines recommend the use of least 4 second-line drugs (a newer fluoroquinolone, an injectable agent, prothionamide, and cycloserine or para-aminosalicylic acid) in addition to pyrazinamide. The kanamycin is the initial choice of injectable durgs, and newer fluoroquinolones include levofloxacin and moxifloxacin. For MDR-TB, especially cases that are extensively drug-resistant, group 5 drugs such as linezolid, clofazimine, and amoxicillin/clavulanate need to be included. New agents with novel mechanisms of action that can be given for shorter durations (9-12 months) for MDR-TB are under investigation.
