Update on drug-resistant pulmonary tuberculosis treatment in hemodialysis patients.

Autor:	Jonny J; Department of Internal Medicine, Gatot Soebroto Central Army Hospital, DKI Jakarta, Indonesia; Faculty of Medicine, Jakarta Veterans National Development University, DKI Jakarta, Indonesia. Electronic address: Jonny_army@yahoo.com., Saraswati PD; Department of Internal Medicine, Gatot Soebroto Central Army Hospital, DKI Jakarta, Indonesia., Ramadhani BP; Department of Internal Medicine, Gatot Soebroto Central Army Hospital, DKI Jakarta, Indonesia., Sitepu EC; Department of Internal Medicine, Gatot Soebroto Central Army Hospital, DKI Jakarta, Indonesia., Pasiak TF; Faculty of Medicine, Jakarta Veterans National Development University, DKI Jakarta, Indonesia.
Jazyk:	angličtina
Zdroj:	The Indian journal of tuberculosis [Indian J Tuberc] 2024; Vol. 71 Suppl 1, pp. S110-S116. Date of Electronic Publication: 2023 Apr 11.
DOI:	10.1016/j.ijtb.2023.04.011
Abstrakt:	World Health Organization (WHO) issued the latest recommendations regarding the management of drug-resistant Tuberculosis (TB) in 2022, allowing the replacement of ethambutol (6 months) with linezolid (2 months). This recommendation also introduced a new regimen, namely bedaquiline, pretomanide, linezolid, moxifloxacin (BPaLM) for fluoroquinolone-sensitive patients and bedaquiline, pretomanide, linezolid, (BPaL) for patients insensitive to fluoroquinolone (6-9 months). The latest TB regimen introduced by WHO provides a shorter-course treatment, however not much has been discussed about the impact of this new regimen on chronic kidney disease (CKD) patients, particularly on hemodialysis (HD). The condition of CKD can interfere with the pharmacokinetics of TB medication, thus could reduce effectiveness and increase toxicity. The drugs used on this new regimen are mostly safe for renal impairment patients due to the dominant metabolism in the liver. Particular precaution is given to the administration of linezolid due to increased hematology side effects and bedaquiline with the side effect of QTC interval lengthening and increased risk of arrhythmias. Although this regimen research has not been in many studies in renal failure patients, no significant side effects nor kidney damage evidence was found. This remains to be proven by more research on the patient population with renal failure. Competing Interests: Conflict of interest The authors have none to declare. (Copyright © 2023 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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