Management of Multidrug-Resistant Tuberculosis

Author:

Caminero Jose12,Daley Charles345

Affiliation:

1. Servicio de Neumologia, Hospital General de Gran Canaria, Las Palmas, Canary Islands, Spain

2. International Union against Tuberculosis and Lung Disease (The Union), Paris, France

3. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, Colorado

4. Division of Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado Denver, Aurora, Colorado

5. Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, Colorado

Abstract

AbstractDrug-resistant strains of Mycobacterium tuberculosis pose a major threat to global tuberculosis control. Despite the availability of curative antituberculosis therapy for nearly half a century, inappropriate and inadequate treatment of tuberculosis, as well as unchecked transmission of M. tuberculosis, has resulted in alarming levels of drug-resistant tuberculosis. The World Health Organization (WHO) estimates that there were 600,000 cases of multidrug-resistant tuberculosis (MDR-TB)/rifampin-resistant (RR) tuberculosis in 2016, defined as strains that are resistant to at least isoniazid and rifampicin. Globally, WHO estimates that 4.1% of new tuberculosis cases and 19% of retreatment cases have MDR-TB. By the end of 2016, 123 countries had reported at least one case of extensively drug-resistant strains, which are MDR-TB strains that have acquired additional resistance to fluoroquinolones and at least one second-line injectable. It is estimated that only 22% of all MDR-TB cases are currently receiving therapy. This article reviews the management of MDR/RR-TB and updates recommendations regarding the use of shorter course regimens and new drugs.

Publisher

Georg Thieme Verlag KG

Subject

Critical Care and Intensive Care Medicine,Pulmonary and Respiratory Medicine

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