Introduction and scaling up of new drugs for drug-resistant TB: experiences from the Americas
Autor: | Massimo Ghidinelli, E. Montoro, K. Westby, Rafael López, O. Bernal, Pedro Avedillo |
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Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Tuberculosis Antitubercular Agents 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tuberculosis Multidrug-Resistant medicine Humans 030212 general & internal medicine Intensive care medicine Adverse effect business.industry Drug resistant tuberculosis medicine.disease Regimen Infectious Diseases Pharmaceutical Preparations 030228 respiratory system chemistry Donation Drug Therapy Combination Health organization Americas Delamanid Bedaquiline business medicine.drug |
Zdroj: | The International Journal of Tuberculosis and Lung Disease. 24:1058-1062 |
ISSN: | 1027-3719 |
DOI: | 10.5588/ijtld.20.0111 |
Popis: | The number of multidrug-resistant tuberculosis (MDR-TB) cases reported in the Americas has increased by 21.2%, from 3737 in 2016 to 4791 in 2018. The WHO has been recommending changes on the treatment of DR-TB, moving from long-duration treatment with injectables to a short oral regimen with new drugs such as bedaquiline (BDQ) and delamanid (DLM), in selected cases and only under programmatic conditions. Injectables are no longer recommended by the WHO due to lower efficacy and the increasing seriousness of adverse events. The introduction of new oral drugs for DR-TB received a boost with a global donation of BDQ to some eligible countries, which continues with the countries purchasing drugs through the Pan American Health Organization Strategic Fund. The main challenges in the scaling up of new drugs for DR-TB include low DR-TB detection rate, the slow pace in transitioning to molecular testing and delays in the introduction of new oral short regimens for MDR-TB. The Americas need to accelerate the scale up of new oral treatments, improve detection rates, increase molecular diagnosis of resistance, and ensure the registration and introduction of the shorter treatment regimen in national MDR-TB guidelines. |
Databáze: | OpenAIRE |
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