10.4.1
Treatment approach
National TB Management Guidelines, 2018 Edition. Chapter 10, Programmatic and Clinical Management of Drug-Resistant TB.
Clinical description
Treatment of patients with DR-TB involves second-line drugs. They are much more expensive, less effective and have more adverse drug reaction than first-line TB drugs.
Groups of Anti-TB Drugs The anti-TB drugs have traditionally been divided into first- and second-line anti-TB drugs with isoniazid, rifampicin, pyrazinamide, ethambutol and streptomycin being the primary first-line anti-TB drugs.
This regrouping is intended to guide the design of individualized regimen, for shorter regimen lasting 9-12 months the composition is usually standardized15.
15 World Health Organization treatment guidelines for drug-resistant tuberculosis: 2016 update.
76 National Tuberculosis Control Programme Table 10.4-1: Medicines recommended for the treatment rifampicin resistant and multidrug – resistant TB A. Fluoroquinolones 16 Levofloxacin Lfx Mfx Moxifloxacin Gfx Gatifloxacin B. Second-line injectable agents Amikacin Am Capreomycin Cm Kanamycin Km (Streptomycin)17 (S)
C. Other core second-line agents2 Ethionamide / Prothionamide Eto / Pto Cycloserine / Terizidone Cs / Trd Linezolid Lzd Clofazimine Cfz D. Add-on agents (not part of the D1 Pyrazinamide Z core DR-TB regimen) Ethambutol E High-dose isoniazid Hh D2 Bedaquilline Bdq Delamanid Dlm D3 p-amino salicylic acid PAS Imipenem-cilastatin18 Ipm Meropenem4 Mpm Amoxicillin-clavulanate4 Amx-Clv (T)
16 17 18
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