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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)).
[8] [9] [10] Treatment of MDR-TB requires second-line drugs (i.e., fluoroquinolones, aminoglycosides, and others), which in general are less effective, more toxic and much more expensive than first-line drugs. [8] Treatment schedules for MDR-TB involving fluoroquinolones and aminoglycosides can run for two years, compared to the six months of ...
Capreomycin is an antibiotic which is given in combination with other antibiotics for the treatment of tuberculosis. [1] Specifically it is a second line treatment used for active drug resistant tuberculosis. [1] It is given by injection into a vein or muscle. [1]
Extensively drug-resistant TB is also resistant to three or more of the six classes of second-line drugs. [155] Totally drug-resistant TB is resistant to all currently used drugs. [ 156 ] It was first observed in 2003 in Italy, [ 157 ] but not widely reported until 2012, [ 156 ] [ 158 ] and has also been found in Iran and India. [ 159 ]
For the treatment of tuberculosis, cycloserine is classified as a second-line drug. Its use is only considered if one or more first-line drugs cannot be used. Hence, cycloserine is restricted for use only against multiple drug-resistant and extensively drug-resistant strains of M. tuberculosis.
If these drugs are misused or mismanaged, multidrug-resistant TB (MDR-TB) can develop. MDR-TB takes longer to treat with second-line drugs (i.e., amikacin, kanamycin, or capreomycin), which are more expensive and have more side-effects. XDR-TB can develop when these second-line drugs are also misused or mismanaged and become ineffective.
Its potency is less than that of the current five first-line drugs (isoniazid, rifampicin, ethambutol, pyrazinamide, and streptomycin) for treating tuberculosis and its cost is higher, but it is still useful in the treatment of multidrug-resistant tuberculosis. [8] PAS is always used in combination with other anti-TB drugs. [citation needed]
The term was first presented in 2006, in which it showed that TB was resistant to many second line drugs and possibly all the medicines used to treat the disease. Lack of testing made it unclear which drugs the TDR-TB were resistant to. The emergence of TDR-TB has been documented in four major publications.