Challenges and Controversies in Defining Totally Drug-Resistant Tuberculosis

Autor: Peter Cegielski, Paul Nunn, Ekaterina V. Kurbatova, Karin Weyer, Tracy L. Dalton, Douglas F. Wares, Michael F. Iademarco, Kenneth G. Castro, Mario Raviglione
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Zdroj: Emerging Infectious Diseases, Vol 18, Iss 11, Pp - (2012)
Druh dokumentu: article
ISSN: 1080-6040
1080-6059
DOI: 10.3201/eid1811.120526
Popis: In March 2012, in response to reports of tuberculosis (TB) resistant to all anti-TB drugs, the World Health Organization convened an expert consultation that identified issues to be resolved before defining a new category of highly drug-resistant TB. Proposed definitions are ambiguous, and extensive drug resistance is encompassed by the already defined extensively drug-resistant (XDR) TB. There is no evidence that proposed totally resistant TB differs from strains encompassed by XDR TB. Susceptibility tests for several drugs are poorly reproducible. Few laboratories can test all drugs, and there is no consensus list of all anti-TB drugs. Many drugs are used off-label for highly drug resistant TB, and new drugs formulated to combat resistant strains would render the proposed category obsolete. Labeling TB strains as totally drug resistant might lead providers to think infected patients are untreatable. These challenges must be addressed before defining a new category for highly drug-resistant TB.
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