Threat of MDR tuberculosis- Is short term treatment of TB drugs promising?
SNMedical College, Agra, India
Global TuberculosisReport 2017WHO estimates that there were 600 000 new cases with resistance to rifampicin - the most effective first-line drug, of which 490 000 had MDR-TB.The countries with the largest numbers of MDR/RR-TB cases (47% of the global total) were in China, India and the Russian Federation. Globally, data show an average cure rate of only 54% for treated MDR-TB patients.
At least 35 countries have introduced shorter MDR-TB regimens.As part of efforts to improve outcomes for MDR/XDR-TB, 89 countries and territories had started using bedaquilineand 54 had used delamanidby June 2017.
Longer MDR-TB regimens are treatments for RR-TB or MDR-TB which last 18 months ormore and which may be standardized or individualized. These regimens were previously qualified as“conventional”, having been the mainstay of MDR-TB treatment before the 2016 update.
As per 2016 guidelines update in patients with RR-TB or MDR-TB who were not previously treated with second-line drugs and in whom resistance to fluoroquinolones and second-line injectable agents was excluded or is considered highly unlikely, a shorter MDR-TB regimen of 9–12 months may be used instead of the longer regimen.Thesepatients had a statisticallysignificant higher likelihood of treatment success than those who received longer regimens.
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