Management of Patients with Multidrug-Resistant Tuberculosis
INT J TUBERC LUNG DIS 23(6):645–662 STATE OF THE ART Q 2019 The Union http://dx.doi.org/10.5588/ijtld.18.0622 STATE OF THE ART SERIES MDR-TB Series editors: C Horsburgh, Christoph Lange and Carole Mitnick NUMBER 4 IN THE SERIES Management of patients with multidrug-resistant tuberculosis C. Lange, R. E. Aarnoutse, J. W. C. Alffenaar, G. Bothamley, F. Brinkmann, J. Costa, D. Chesov, R. van Crevel, M. Dedicoat, J. Dominguez, R. Duarte, H. P. Grobbel, G. Gunther,¨ L. Guglielmetti, J. Heyckendorf, A. W. Kay, O. Kirakosyan, O. Kirk, R. A. Koczulla, G. G. Kudriashov, L. Kuksa, F. van Leth, C. Magis-Escurra, A. M. Mandalakas, B. Molina-Moya, C. A. Peloquin, M. Reimann, R. Rumetshofer, H. S. Schaaf, T. Schon, ¨ S. Tiberi, J. Valda, P. K. Yablonskii, K. Dheda Please see Supplementary Data for details of all author affiliations. SUMMARY The emergence of multidrug-resistant tuberculosis availability of novel drugs such as bedaquiline allow us to (MDR-TB; defined as resistance to at least rifampicin design potent and well-tolerated personalised MDR-TB and isoniazid) represents a growing threat to public treatment regimens based solely on oral drugs. In this health and economic growth. Never before in the history article, we present management guidance to optimise the of mankind have more patients been affected by MDR- diagnosis, algorithm-based treatment, drug dosing and TB than is the case today. The World Health Organiza- therapeutic drug monitoring, and the management of tion reports that MDR-TB outcomes are poor despite adverse events and comorbidities, associated with MDR- staggeringly high management costs.
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