Multidrug-resistant tuberculosis

Sharma, S. K. ; Mohan, A. (2004) Multidrug-resistant tuberculosis Indian Journal of Medical Research, 120 (4). pp. 354-376. ISSN 0971-5916

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Abstract

Multidrug-resistant tuberculosis (MDR-TB) caused by Mycobacterium tuberculosis resistant to both isoniazid and rifampicin with or without resistance to other drugs is among the most worrisome elements of the pandemic of antibiotic resistance. Globally, about three per cent of all newly diagnosed patients have MDR-TB. The proportion is higher in patients who have previously received antituberculosis treatment reflecting the failure of programmes designed to ensure complete cure of patients with tuberculosis. While host genetic factors may probably contribute, incomplete and inadequate treatment is the most important factor leading to the development of MDR-TB. The definitive diagnosis of MDR-TB is difficult in resource poor low income countries because of non-availability of reliable laboratory facilities. Efficiently run tuberculosis control programmes based on directly observed treatment, short-course (DOTS) policy is essential for preventing the emergence of MDR-TB. Management of MDR-TB is a challenge which should be undertaken by experienced clinicians at centres equipped with reliable laboratory service for mycobacterial culture and in vitro sensitivity testing as it requires prolonged use of expensive second-line drugs with a significant potential for toxicity. Judicious use of drugs, supervised individualised treatment, focussed clinical, radiological and bacteriological follow up, use of surgery at the appropriate juncture are key factors in the successful management of these patients. In certain areas, currently available programme approach may not be adequate and innovative approaches such as DOTS-plus may have to be employed to effectively control MDR-TB.

Item Type:Article
Source:Copyright of this article belongs to Indian Council of Medical Research.
Keywords:Diagnosis; Epidemiology; Multidrug-resistant Tuberculosis (MDR-TB); Predictors for Development; Prognostic Factors; Treatment
ID Code:69211
Deposited On:08 Nov 2011 11:27
Last Modified:18 May 2016 15:42

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