Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence
| Autor: | K G Koura, V Schwoebel, Armand Van Deun, Tom Decroo, Arnaud Trébucq, Alberto Piubello, Chen Yuan Chiang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Tuberculosis lcsh:Medicine Review 03 medical and health sciences 0302 clinical medicine Moxifloxacin Levofloxacin outcome analysis MDR medicine 9-month regimen Short course 030212 general & internal medicine fluoroquinolones Intensive care medicine Adverse effect 0303 health sciences treatment 030306 microbiology business.industry lcsh:R General Medicine medicine.disease Gatifloxacin Multiple drug resistance Regimen tuberculosis business medicine.drug |
| Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 9, Iss 1, p 55 (2019) |
| ISSN: | 2077-0383 |
| Popis: | About ten years ago, the first results of the so-called “Bangladesh regimen”, a short regimen lasting nine months instead of 20 months, revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment. Similar short regimens were studied in different settings, relying for their efficacy on a later generation fluoroquinolone, either gatifloxacin, moxifloxacin, or levofloxacin. We review the published material on short MDR-TB regimens, describe their different compositions, their results in national tuberculosis programs in middle- and low-income countries, the risk of acquiring resistance to fluoroquinolone, and the occurrence of adverse events. With over 80% success, the regimen performs much better than longer regimens (usually around 50%). Monitoring of adverse events allows adapting its composition to prevent severe adverse events such as deafness. We discuss the current applicability and usefulness of the short injectable-containing regimen given the 2019 recommendation of the World Health Organization (WHO) for a new long all-oral regimen. We conclude that the most effective fluoroquinolone is gatifloxacin, currently not listed as an essential medicine by WHO. It is a priority to restore its status as an essential medicine. |
| Databáze: | OpenAIRE |
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