Treatment of drug-resistant tuberculosis: Review Ilaca dirençli tüberkülozun tedavisi
Turkiye Klinikleri Journal of Medical Sciences, cilt.32, sa.3, ss.788-804, 2012 (Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 32 Sayı: 3
- Basım Tarihi: 2012
- Doi Numarası: 10.5336/medsci.2011-24602
- Dergi Adı: Turkiye Klinikleri Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.788-804
- Anahtar Kelimeler: Mycobacterium tuberculosis, tuberculosis, multidrug resistant tuberculosis, extensively drug resistant tuberculosis, antituberculous agents
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Drug-resistant tuberculosis (TB) is a significant manmade problem resulting from chemotherapy use. Extensively drug-resistant (XDR) TB is the development of resistance against any fluoroquinolones and at least one of the injectable second line anti-TB drugs in addition to resistance against isoniazide and rifampicin, first line anti-TB drugs, (definition of multidrug-resistant- MDR-TB). Emergence of XDR-TB made treatment of MDR-TB patients much more significant. Finally, a novel TB form (extremely drug-resistant-XXDR-TB) that is resistant to all first and second line anti-TB drugs detected in a few cases worldwide is defined as "TB resistant to all drugs". Treatment of patients with MDR and XDR-TB requires long term and monitored use of second line anti-TB drugs as isoniazide and rifampicin cannot be used. Treatment of MDR and XDR-TB patients should be managed by experienced specialists in institutions that are adequately equipped and have reliable laboratories that may perform first line and second line anti-TB susceptibility tests besides TB culture. Multidrug regimens composed of 4-6 drugs to which the infecting microorganism is susceptible should be used for at least 18-24 months to cure patients with MDR and XDR-TB. Treatment regimen should include a parenteral drug and this drug should be continued to be used for at least four months after cultures become negative. This review includes drugs that are used for the treatment of drug resistant TB forms, mainly MDR that has regained importance recently and newly defined XDR-TB, adverse effects of the drugs, treatment principles, follow-up and outcomes of treatment. © 2012 by Türkiye Klinikleri.