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Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis

Caminero, José A. and Sotgiu, Giovanni and Zumla, Alimuddin and Migliori, Giovanni Battista (2010) Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis. The Lancet Infectious Diseases, Vol. 10 (9), p. 621-629. eISSN 1474-4457. Article.

Full text not available from this repository.

DOI: 10.1016/S1473-3099(10)70139-0

Abstract

Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are generally thought to have high mortality rates. However, many cases can be treated with the right combination and rational use of available antituberculosis drugs. This Review describes the evidence available for each drug and discusses the basis for recommendations for the treatment of patients with MDR and XDR tuberculosis. The recommended regimen is the combination of at least four drugs to which the Mycobacterium tuberculosis isolate is likely to be susceptible. Drugs are chosen with a stepwise selection process through five groups on the basis of efficacy, safety, and cost. Among the first group (the oral first-line drugs) high-dose isoniazid, pyrazinamide, and ethambutol are thought of as an adjunct for the treatment of MDR and XDR tuberculosis. The second group is the fluoroquinolones, of which the first choice is high-dose levofloxacin. The third group are the injectable drugs, which should be used in the following order: capreomycin, kanamycin, then amikacin. The fourth group are called the second-line drugs and should be used in the following order: thioamides, cycloserine, then aminosalicylic acid. The fifth group includes drugs that are not very effective or for which there are sparse clinical data. Drugs in group five should be used in the following order: clofazimine, amoxicillin with clavulanate, linezolid, carbapenems, thioacetazone, then clarithromycin.

Item Type:Article
ID Code:5538
Status:Published
Refereed:Yes
Uncontrolled Keywords:Antituberculosis drugs, MDR and XDR, M. tuberculosis
Subjects:Area 06 - Scienze mediche > MED/01 Statistica medica
Divisions:001 Università di Sassari > 03 Istituti > Igiene e medicina preventiva
Publisher:Elsevier
eISSN:1474-4457
Deposited On:18 Feb 2011 13:20

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