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Multidrug-resistant tuberculosis

Despite the efforts made worldwide to reduce the number of cases of drug-susceptible tuberculosis, multidrug-resistant tuberculosis (MDR-TB) constitutes an important public health issue. Around 440,000 new cases of MDR-TB are estimated annually, although in 2008 only 7% of these (29,423 cases) were...

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Autores principales: Lemos, Antônio Carlos Moreira, Matos, Eliana Dias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427344/
https://www.ncbi.nlm.nih.gov/pubmed/23477764
http://dx.doi.org/10.1016/j.bjid.2013.01.007
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author Lemos, Antônio Carlos Moreira
Matos, Eliana Dias
author_facet Lemos, Antônio Carlos Moreira
Matos, Eliana Dias
author_sort Lemos, Antônio Carlos Moreira
collection PubMed
description Despite the efforts made worldwide to reduce the number of cases of drug-susceptible tuberculosis, multidrug-resistant tuberculosis (MDR-TB) constitutes an important public health issue. Around 440,000 new cases of MDR-TB are estimated annually, although in 2008 only 7% of these (29,423 cases) were notified. The laboratory tests for diagnosing resistance may be phenotypic (based on culture growth in the presence of drugs) or genotypic (i.e. identification of the presence of mutations that confer resistance). The urgent need for a rapid means of detecting resistance to anti-TB drugs has resulted in the development of many genotypic methods over recent years. The treatment of MDR-TB is expensive, complex, prolonged (18–24 months) and associated with a higher incidence of adverse reactions. Some basic principles must be observed when prescribing an adequate treatment regimen for MDR-TB: (a) the association of at least four drugs (three of which should not have been used previously); (b) use of a fluoroquinolone; and (c) use of an injectable anti-TB drug. In Brazil, the therapeutic regimen for MDR-TB has been standardized and consists of five drugs: terizidone, levofloxacin, pyrazinamide, ethambutol and an aminoglycoside (streptomycin or amikacin). Pulmonary resection is an important tool in the coadjuvant treatment of MDR-TB. While a recent meta-analysis revealed an average cure rate of MDR-TB of 69%, clinical studies are currently being conducted with new drugs and with drugs already available on the market but with a new indication for TB, with encouraging results that will enable more effective treatment regimens to be planned in the future.
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spelling pubmed-94273442022-09-01 Multidrug-resistant tuberculosis Lemos, Antônio Carlos Moreira Matos, Eliana Dias Braz J Infect Dis Special Article Despite the efforts made worldwide to reduce the number of cases of drug-susceptible tuberculosis, multidrug-resistant tuberculosis (MDR-TB) constitutes an important public health issue. Around 440,000 new cases of MDR-TB are estimated annually, although in 2008 only 7% of these (29,423 cases) were notified. The laboratory tests for diagnosing resistance may be phenotypic (based on culture growth in the presence of drugs) or genotypic (i.e. identification of the presence of mutations that confer resistance). The urgent need for a rapid means of detecting resistance to anti-TB drugs has resulted in the development of many genotypic methods over recent years. The treatment of MDR-TB is expensive, complex, prolonged (18–24 months) and associated with a higher incidence of adverse reactions. Some basic principles must be observed when prescribing an adequate treatment regimen for MDR-TB: (a) the association of at least four drugs (three of which should not have been used previously); (b) use of a fluoroquinolone; and (c) use of an injectable anti-TB drug. In Brazil, the therapeutic regimen for MDR-TB has been standardized and consists of five drugs: terizidone, levofloxacin, pyrazinamide, ethambutol and an aminoglycoside (streptomycin or amikacin). Pulmonary resection is an important tool in the coadjuvant treatment of MDR-TB. While a recent meta-analysis revealed an average cure rate of MDR-TB of 69%, clinical studies are currently being conducted with new drugs and with drugs already available on the market but with a new indication for TB, with encouraging results that will enable more effective treatment regimens to be planned in the future. Elsevier 2013-03-09 /pmc/articles/PMC9427344/ /pubmed/23477764 http://dx.doi.org/10.1016/j.bjid.2013.01.007 Text en © 2013 Elsevier Editora Ltda. . https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Special Article
Lemos, Antônio Carlos Moreira
Matos, Eliana Dias
Multidrug-resistant tuberculosis
title Multidrug-resistant tuberculosis
title_full Multidrug-resistant tuberculosis
title_fullStr Multidrug-resistant tuberculosis
title_full_unstemmed Multidrug-resistant tuberculosis
title_short Multidrug-resistant tuberculosis
title_sort multidrug-resistant tuberculosis
topic Special Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427344/
https://www.ncbi.nlm.nih.gov/pubmed/23477764
http://dx.doi.org/10.1016/j.bjid.2013.01.007
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