Drug resistant Tuberculosis
Tuberculosis (TB) causes 1.4 million deaths every year (Dash, 2013). Misuse of anti-tuberculosis drugs and late detection and/or diagnosis has contributed to the emergence of drug-resistant TB (Dash, 2013). Drug resistant tuberculosis is referred to as either multidrug-resistant TB (MDR-TB), or extensively drug-resistant TB (XDR-TB), both of which create obstacles for successful treatment (Lehne, 2013). Lehne (2013) defines MDR-TB as a TB that does not respond to either isoniazide or rifampin. XDR-TB is defined as being resistant to isoniazide and rifampin, as well as fluoroquinolones and at least one second-line TB treatment drug (Lehne, 2013).
Drug resistant TB is a growing global problem, with major implications for TB control programs world-wide. High mortality rates and the emergence of totally drug-resistant TB further threaten the stability of such programs (Calligaro, Moodley, Symons, & Dheda, 2014). Countries with TB endemics have limited access to linezolid, bedaquiline, and other such drugs, thus creating an increase in therapy failure and drug resistance (Calligaro et al., 2014). According to a 2010 report on MDR-TB (Chiang, Centis, & Migliori, 2010), new TB cases with MDR-TB had a median prevalence of 1.6%, and previously treated MDR-TB had a prevalence rate of 11.7%. Approximately half of the identified cases of drug-resistant TB were in India and China; however, experts warn that if detection and treatment rates of MDR-TB worldwide do not increase to meet the World Health Organization’s target, prevalence of XDR-TB will rise exponentially (Chiang et al., 2010). In 2009, 94 cases of MDR-TB were reported and no cases of XDR-TB were reported (Lehne, 2013).
Inadequate drug therapy is the primary cause of drug-resistance among TB patients (Lehne, 2013). Antituberculosis treatment should include a regimen of at least two drugs to which the TB organisms are sensitive, possibly more. First line treatment consists of Isoniazid and rifampin. Drug
Drug resistant TB is a growing global problem, with major implications for TB control programs world-wide. High mortality rates and the emergence of totally drug-resistant TB further threaten the stability of such programs (Calligaro, Moodley, Symons, & Dheda, 2014). Countries with TB endemics have limited access to linezolid, bedaquiline, and other such drugs, thus creating an increase in therapy failure and drug resistance (Calligaro et al., 2014). According to a 2010 report on MDR-TB (Chiang, Centis, & Migliori, 2010), new TB cases with MDR-TB had a median prevalence of 1.6%, and previously treated MDR-TB had a prevalence rate of 11.7%. Approximately half of the identified cases of drug-resistant TB were in India and China; however, experts warn that if detection and treatment rates of MDR-TB worldwide do not increase to meet the World Health Organization’s target, prevalence of XDR-TB will rise exponentially (Chiang et al., 2010). In 2009, 94 cases of MDR-TB were reported and no cases of XDR-TB were reported (Lehne, 2013).
Inadequate drug therapy is the primary cause of drug-resistance among TB patients (Lehne, 2013). Antituberculosis treatment should include a regimen of at least two drugs to which the TB organisms are sensitive, possibly more. First line treatment consists of Isoniazid and rifampin. Drug
References: Dash, M. (2013). Drug resistant tuberculosis: A diagnostic challenge. Journal of Postgraduate Medicine, 59(3), 196. doi:10.4103/0022-3859.118038 Chan, E. D., Strand, M. J., & Iseman, M. D. (2009). Multidrug-resistant tuberculosis (TB) resistant to fluoroquinolones and streptomycin but susceptible to second-line injection therapy has a better prognosis than extensively drug-resistant TB. Clinical Infectious Diseases, 48(5), e50-e52. doi:10.1086/597010 Chiang, C., Centis, R., & Migliori, G. B. (2010). Drug-resistant tuberculosis: Past, present, future. Respirology, 15(3), 413-432. doi:10.1111/j.1440-1843.2010.01738.x Calligaro, G. L., Moodley, L., Symons, G., & Dheda, K. (2014). The medical and surgical treatment of drug-resistant tuberculosis. Journal of Thoracic Disease, 6(3), 186. Retrieved from CINAHL Lehne, R. (2013). Antimycbacterial agents. In Pharmacology for Nursing Care (8ed., pp. 1116-1130). St. Louis, MO: Saunders Elsevier. Stephenson, J. (2009). Treating multidrug-resistant TB. JAMA: The Journal of the American Medical Association, 302(3), 246-246. doi:10.1001/jama.2009.1015