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Review
. 2013 Dec;45(4):367-74.
doi: 10.3947/ic.2013.45.4.367. Epub 2013 Dec 27.

Medical treatment of pulmonary multidrug-resistant tuberculosis

Tae Sun Shim  1 , Kyung-Wook Jo  1
Affiliations
Review

Medical treatment of pulmonary multidrug-resistant tuberculosis

Tae Sun Shim et al. Infect Chemother. 2013 Dec.

Abstract

Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging because of the high toxicity of second-line drugs and the longer treatment duration required compared with drug-susceptible TB. The efficacy of treatment for MDR-TB is poorer than that for drug-susceptible TB. The selection of drugs in MDR-TB is based on previous treatment history, drug susceptibility results, and TB drug resistance patterns in the each region. Recent World Health Organization guidelines recommend the use of least 4 second-line drugs (a newer fluoroquinolone, an injectable agent, prothionamide, and cycloserine or para-aminosalicylic acid) in addition to pyrazinamide. The kanamycin is the initial choice of injectable durgs, and newer fluoroquinolones include levofloxacin and moxifloxacin. For MDR-TB, especially cases that are extensively drug-resistant, group 5 drugs such as linezolid, clofazimine, and amoxicillin/clavulanate need to be included. New agents with novel mechanisms of action that can be given for shorter durations (9-12 months) for MDR-TB are under investigation.

Keywords: Extensively drug-resistant tuberculosis; Multidrug-resistant; Therapeutics; Tuberculosis.

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Conflict of interest statement

No conflicts of interest.

References

    1. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis. Geneva, Switzerland: WHO; 2008. - PubMed
    1. Yew WW, Chan CK, Leung CC, Chau CH, Tam CM, Wong PC, Lee J. Comparative roles of levofloxacin and ofloxacin in the treatment of multidrug-resistant tuberculosis: preliminary results of a retrospective study from Hong Kong. Chest. 2003;124:1476–1481. - PubMed
    1. Lee J, Lee CH, Kim DK, Yoon HI, Kim JY, Lee SM, Yang SC, Lee JH, Yoo CG, Lee CT, Chung HS, Kim YW, Han SK, Yim JJ. Retrospective comparison of levofloxacin and moxifloxacin on multidrug-resistant tuberculosis treatment outcomes. Korean J Intern Med. 2011;26:153–159. - PMC - PubMed
    1. Koh WJ, Lee SH, Kang YA, Lee CH, Choi JC, Lee JH, Jang SH, Yoo KH, Jung KH, Kim KU, Choi SB, Ryu YJ, Chan Kim K, Um S, Kwon YS, Kim YH, Choi WI, Jeon K, Hwang YI, Kim SJ, Lee YS, Heo EY, Lee J, Ki YW, Shim TS, Yim JJ. Comparison of levofloxacin versus moxifloxacin for multidrug-resistant tuberculosis. Am J Respir Crit Care Med. 2013;188:858–864. - PubMed
    1. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis - 2011 update. Geneva, Switzerland: WHO; 2011. - PubMed