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Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications (drugs): isoniazid and rifampicin. Some forms of TB are also resistant to second-line medications, and are called extensively drug-resistant TB .
The second-line drugs (WHO groups 2, 3, and 4) are only used to treat disease that is resistant to first line therapy (i.e., for extensively drug-resistant tuberculosis (XDR-TB) or multidrug-resistant tuberculosis (MDR-TB)).
Totally drug-resistant tuberculosis (TDR-TB) is a generic term for tuberculosis strains that are resistant to a wider range of drugs than strains classified as extensively drug-resistant tuberculosis. Extensively drug resistant tuberculosis is tuberculosis that is resistant to isoniazid and rifampicin, any fluoroquinolone, and any of the three ...
Combination therapies are essential for treating active tuberculosis infections. Currently, there are four first-line tuberculosis drugs given as a combination therapy over an extended period of time. Some strains of the tuberculosis pathogen are resistant to two (called MDR-TB) or at least four (called XDR-TB) first-line tuberculosis drugs. [13]
The Microscopic Observation Drug Susceptibility assay (MODS) is a culture method shown to be more sensitive, faster and cheaper test than current culture-based tests for Tuberculosis. The Microscopic Observation Drug Susceptibility assay (MODS) involves direct observation of Mycobacterium tuberculosis and simultaneously yields drug-resistance.
[221] [222] [223] In addition to being fast-acting, the test can determine if there is resistance to the antibiotic rifampicin which may indicate multi-drug resistant tuberculosis and is accurate in those who are also infected with HIV. [221] [224] Many resource-poor places as of 2011 have access to only sputum microscopy. [225]
An All-Oral 6-Month Regimen for Multidrug-Resistant TB (the NExT Study): A Multicenter, Randomized Controlled Trial. Am J Respir Crit Care Med. 2022. 15;205(10):1214-1227. (Senior author; IF = 24.7) Pietersen E,.., Dheda K. Long-term outcomes of patients with extensively drug-resistant tuberculosis in South Africa: a cohort study.
The drug proved better than streptomycin, which had nerve toxicity and to which TB could easily develop resistance. In the 1948, researchers at Britain's Medical Research Council demonstrated that combined treatment with streptomycin and PAS was superior to either drug alone, and established the principle of combination therapy for tuberculosis ...