Recent advances in the medical and surgical treatment of multi-drug resistant tuberculosis

  title={Recent advances in the medical and surgical treatment of multi-drug resistant tuberculosis},
  author={Umesh G. Lalloo and Rishendran Naidoo and Anish Ambaram},
  journal={Current Opinion in Pulmonary Medicine},
Purpose of review Multi-drug resistant tuberculosis is a serious clinical problem. Extension of drug resistance to second-line anti-tuberculosis drugs in the form of the W-strain is cause for alarm. There is an urgent need for more rapid recognition of multi-drug resistant tuberculosis and newer therapeutic agents. This review summarizes the recent advances in the diagnosis and treatment of multi-drug resistant tuberculosis including surgery and new developments. Recent findings Multidrug… 
Treatment of multidrug-resistant and extensively drug-resistant tuberculosis: current status and future prospects
The roles of surgery and immunotherapy in the management of MDR-TB require further evaluation and strengthening of directly observed treatment, short-course and drug-resistance programs, alongside other strategies, including the development of newer diagnostics and drugs, is mandatory.
Management of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis: current status and future prospects.
  • W. Yew
  • Medicine, Biology
    Kekkaku : [Tuberculosis]
  • 2011
Given the escalating size of the problem of MDR- TB and XDR-TB worldwide, gigantic instillation of resources is required for control of this formidable challenge, largely through more accurate and rapid drug susceptibility testing (especially for rifampicin and fluoroquinolone) and regular drug-resistance surveillance.
Treatment of tuberculosis: update 2010
New antituberculosis drugs are urgently needed to improve the present standard short-course and alternative chemotherapies, by shortening administration durations and increasing cure rates, through the greater potency of these agents.
New Antituberculous Drugs in Development
There is a need for drugs that are safe, effective against resistant strains, are able to shorten the course of treatment, are effective for latent TB infection, and that have minimal interactions with antiretroviral drugs.
The medical and surgical treatment of drug-resistant tuberculosis.
Healthcare workers, researchers, and policy makers in TB endemic and non-endemic countries should familiarise themselves with issues relevant to the management of patients with resistance beyond XDR-TB, given the burgeoning global phenomenon.
Tuberculosis, drug resistance, and HIV/AIDS: A triple threat
  • G. Friedland
  • Medicine, Biology
    Current infectious disease reports
  • 2007
This review discusses current information about the distribution of multiple drug- resistant and newer extensively drug-resistant TB as well as available diagnostic and therapeutic strategies with an emphasis on the relationship between TB drug resistance and HIV/AIDS.
Extensively drug-resistant tuberculosis: a new face to an old pathogen.
The current global status of drug-resistant tuberculosis is described and the development of resistance, current management, and strategies for control are discussed.
Management of multidrug‐resistant tuberculosis: Update 2007
Abstract:  Multidrug‐resistant tuberculosis (MDR‐TB) with bacillary resistance to at least isoniazid and rifampicin in vitro is a worldwide phenomenon. Hot spots of the disease are found scattered in
Treatment as prevention and other interventions to reduce transmission of multidrug-resistant tuberculosis.
Although many gaps remain in the biological understanding of TB transmission, implementation barriers to early diagnosis and rapid initiation of effective DR-TB treatment can and must be overcome if the authors are to impactDR-TB incidence in the short and long term.


Pulmonary resection for multi-drug resistant tuberculosis.
Surgery remains an important adjunct to medical therapy for the treatment of multi-drug resistant Mycobacterium tuberculosis in the setting of localized disease, persistent sputum positivity, or patient intolerance of medical therapy, pulmonary resection should be undertaken.
Long-Term Tolerance and Effectiveness of Moxifloxacin Therapy for Tuberculosis: Preliminary Results
Combination therapy including moxifloxacin for TB seems to be as active as the standard therapy in patients with complex illness and well tolerated, according to the observed patients.
Fluoroquinolones, tuberculosis, and resistance.
A small-molecule nitroimidazopyran drug candidate for the treatment of tuberculosis
It is concluded that nitroimidazopyrans offer the practical qualities of a small molecule with the potential for the treatment of tuberculosis and bactericidal activity against both replicating and static M. tuberculosis.
Community based approaches to the control of multidrug resistant tuberculosis: introducing “DOTS-plus”
It is revealed that multidrug resistant tuberculosis has already become established worldwide, with focal “hot zones” of increased transmission in several countries—including Russia, Estonia, Latvia, Cote d'Ivoire, and the Dominican Republic—and in settings of high transmission of multidrog resistant tuberculosis, “DOTS-plus” is warranted.
Treatment and outcome analysis of 205 patients with multidrug-resistant tuberculosis.
Surgical resection and fluoroquinolone therapy were associated with improved microbiological and clinical outcomes in the 205 patients studied after adjusting for other variables, and the improvement was statistically significant for surgery and among older patients for fluoroquolone Therapy.
Moxifloxacin-containing regimen greatly reduces time to culture conversion in murine tuberculosis.
Using a murine model that is representative of chemotherapy for human tuberculosis, the combination of moxifloxacin, rifampin, and pyrazinamide reduced the time needed to eradicate Mycobacterium tuberculosis from the lungs of infected mice by up to 2 months when compared with the standard regimen.
Trends in drug-resistant tuberculosis in the United States, 1993-1996.
The widespread extent of isoniazid resistance confirms the need for drug susceptibility testing to guide optimal treatment of patients with culture-positive disease and indicates the percentage of MDR TB has decreased, although the national trend was significantly influenced by the marked decrease in New York City.
Acquired Rifamycin Resistance in Persons With Advanced HIV
Rifamycin drugs (i.e., rifampin, rifabutin, and rifapentine) are essential for short-course chemotherapy in persons with active tuberculosis (TB). However, adverse drug-drug interactions complicate