Management of drug resistant tuberculosis: isoniazid resistant, rifampicin resistant, multi drug resistant, and extensively drug resistant

Abstract

Mycobacterium tuberculosis strains that are resistant to an elevating number of second-line medicines used to treat multidrug-resistant tuberculosis are becoming a threat to public health worldwide. Recent guidelines recommended at least 20 months of treatment, but recent regimens are toxic, poorly tolerated and insufficiently effective, with cure rates as low as 36% and failure rates as high as 50%. The emergence of multidrug-resistant tuberculosis can be defined as strains resistant to at least isoniazid and rifampin has introduced as they are challenging, but overcome the complexities to tuberculosis programs that have responded by treating multidrug-resistant tuberculosis with second-line drugs. Longer multidrug-resistant tuberculosis regimens are treatments for rifampicin resistant tuberculosis or multidrug-resistant tuberculosis which last 18 months or more according to the new 2019 updated World Health Organization drug-resistant tuberculosis guidelines and which may be standardized or individualized. Longer multidrug-resistant tuberculosis regimens are usually designed to involve a minimum number of second-line tuberculosis medicines considered to be effective based on patient history or drug-resistance patterns. The exact number of drugs used to treat extensively tuberculosis drug-resistant is unknown, but most individuals will receive five to six drugs. Identically, as the majority of patients with extensively tuberculosis drug-resistant have been previously treated for multidrug-resistant tuberculosis, prior exposure to drugs like ethionamide and terizidone frequently excludes their use.