Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Mar;110(3):163-72.
doi: 10.1093/trstmh/trv107.

Management of multidrug-resistant TB: novel treatments and their expansion to low resource settings

Derek J Sloan  1 , Joseph M Lewis  2
Affiliations
Review

Management of multidrug-resistant TB: novel treatments and their expansion to low resource settings

Derek J Sloan et al. Trans R Soc Trop Med Hyg. 2016 Mar.

Abstract

Despite overall progress in global TB control, the rising burden of multidrug-resistant TB (MDR-TB) threatens to undermine efforts to end the worldwide epidemic. Of the 27 countries classified as high burden for MDR-TB, 17 are in 'low' or 'low-middle' income countries. Shorter, all oral and less toxic multidrug combinations are required to improve treatment outcomes in these settings. Suitability for safe co-administration with HIV drugs is also desirable. A range of strategies and several new drugs (including bedaquiline, delamanid and linezolid) are currently undergoing advanced clinical evaluations to define their roles in achieving these aims. However, several clinical questions and logistical challenges need to be overcome before these new MDR-TB treatments fulfil their potential.

Keywords: Bedaquiline; Delamanid; Extensively drug-resistant; Linezolid; Multidrug-resistant; Tuberculosis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
High-burden multidrug-resistant TB (MDR-TB) countries by income status. According to the World Bank, low-income economies are defined as those with an annual Gross National Income (GNI) per capita of US$12 746.
Figure 2.
Figure 2.
WHO recommended groupings of multidrug-resistant TB (MDR-TB) drugs.
Figure 3.
Figure 3.
Current WHO recommended design of multidrug-resistant TB regimens. aThere are conditions in which additional drugs are used. These conditions are applicable when the effectiveness for one or more drugs is unlikely or questionable. One important example of this would be treatment of extensively drug-resistant TB (XDR-TB). If an appropriate regimen cannot be constructed using Group 1–4 drugs, Group 5 drugs may be used. bSome examples of high cross-resistance include: there is high cross-resistance between isoniazid and prothionamide/ethionamide if the InhA mutation is present in the Mycobacterium tuberculosis isolate, amikacin and kanamycin have very high cross-resistance, fluroquinolones have variable cross-resistance.
See this image and copyright information in PMC

References

    1. WHO. MDG6: TB Target Acheived. Geneva: World Health Organization; 2015. http://www.who.int/tb/MDG_TBsuccess_factsheet.pdf [accessed 10 December 2015].
    1. Uplekar M, Weil D, Lonnroth K et al. . WHO's new End TB Strategy. Lancet 2015;385:1799–801. - PubMed
    1. WHO. Global Tuberculosis Report 2014. Geneva: World Health Organization; 2014.
    1. WHO. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis. Geneva: World Health Organization; 2014. - PubMed
    1. Lange C, Abubakar I, Alffenaar J-WC et al. . Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement. Eur Respir J 2014;44:23–63. - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources