Problem

Drug-resistant tuberculosis

Other Names:
Multiply drug-resistant TB
Re-emergent tuberculosis
Nature:

Tuberculosis management describes the techniques and procedures utilized for treating tuberculosis (TB).

The medical standard for active TB is a short course treatment involving a combination of isoniazid, rifampicin (also known as Rifampin), pyrazinamide, and ethambutol for the first two months. During this initial period, Isoniazid is taken alongside pyridoxal phosphate to obviate peripheral neuropathy. Isoniazid is then taken coincident with rifampicin for the remaining four months of treatment. A patient is considered free of all living TB bacteria after six months.

Latent tuberculosis or latent tuberculosis infection (LTBI) is treated with three to nine months of isoniazid alone. This long-term treatment often risks the development of hepatotoxicity. A combination of isoniazid plus rifampicin for a period of three to four months is shown to be an equally effective method for treating LTBI, while mitigating risks to hepatotoxicity. Treatment of LTBI is essential in preventing the spread of active TB.

Incidence:
Hospital staff in developed countries do not expect tubercular patients. In Italy, the sanatoria for TB victims was dismantled in the 1970's. Hospital staff may fail to isolate tubercular patients or decontaminate equipment properly to prevent the spread of the disease. In addition, their tuberculosis is now often virtually untreatable, being deadlier than both the Ebola virus and the bubonic plague.

Doctors may fail to prescribe the full range of drugs required and the patient stops taking drugs when he feels better, even though he may not be cured. These two practices enhance drug resistance.

It will cost governments and the drug industry $500 million a year to prevent a resurgence of tuberculosis. One therapy that works is DOTS, or directly observed treatment short-course, which involves monitoring the patient's drug-taking over the entire lengthy course of treatment.

Treating normal tuberculosis costs about $11 per patient, but medicines for drug-resistant TB can cost up to $250,000 per patient and still fail to cure him. Obviously, it is critical to cure TB before it becomes drug-resistant.

Broader Problems:
Tuberculosis
Tuberculosis
Problem Type:
G: Very specific problems
Date of last update
04.10.2020 – 22:48 CEST