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Title: Extensively drug-resistant tuberculosis: epidemiology and management
Authors: Matteelli, Alberto
Roggi, Alberto
Carvalho, Anna C. C.
Affilliation: University of Brescia. WHO Collaborating Centre for TB/HIV Co-Infection. Institute of Infectious and Tropical Diseases. Brescia, Italy.
University of Brescia. WHO Collaborating Centre for TB/HIV Co-Infection. Institute of Infectious and Tropical Diseases. Brescia, Italy.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Laboratório de Inovações em Terapias, Educação e Bioprodutos. Rio de Janeiro, RJ, Brasil.
Abstract: The advent of antibiotics for the treatment of tuberculosis (TB) represented a major breakthrough in the fight against the disease. However, since its first use, antibiotic therapy has been associated with the emergence of resistance to drugs. The incorrect use of anti-TB drugs, either due to prescription errors, low patient compliance, or poor quality of drugs, led to the widespread emergence of Mycobacterium tuberculosis strains with an expanding spectrum of resistance. The spread of multidrug-resistant (MDR) strains (ie, strains resistant to both isoniazid and rifampicin) has represented a major threat to TB control since the 1990s. In 2006, the first cases of MDR strains with further resistance to fluoroquinolone and injectable drugs were described and named extensively drug-resistant TB (XDR-TB). The emergence of XDR-TB strains is a result of mismanagement of MDR cases, and treatment relies on drugs that are less potent and more toxic than those used to treat drug-susceptible or MDR strains. Furthermore, treatment success is lower and mortality higher than achieved in MDR-TB cases, and the number of drugs necessary in the intensive phase of treatment may be higher than the four drugs recommended for MDR-TB. Linezolid may represent a valuable drug to treat cases of XDR-TB. Delamanid, bedaquiline, and PA-824 are new anti-TB agents in the development pipeline that have the potential to enhance the cure rate of XDR-TB. The best measures to prevent new cases of XDR-TB are the correct management of MDR-TB patients, early detection, and proper treatment of existing patients with XDR-TB.
Keywords: XDR-TB
keywords: Epidemiologia
Resistência a Medicamentos
Issue Date: 2014
Publisher: Dovepress
Citation: MATTEELLI, Alberto; ROGGI, Alberto; CARVALHO, Anna C. C. Extensively drug-resistant tuberculosis: epidemiology and management. Clinical Epidemiology, v.2014:6, p.111-118, 2014.
DOI: 10.2147/CLEP.S35839
ISSN: 1179-1349
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos

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