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As of October 2006, "Extensively drug-resistant tuberculosis" (XDR-TB) is defined as MDR-TB that is resistant to quinolones and also to any one of kanamycin, capreomycin, or amikacin. [76] The old case definition of XDR-TB is MDR-TB that is also resistant to three or more of the six classes of second-line drugs. [77]
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.
For patients with RR-TB or MDR-TB, "not previously treated with second-line drugs and in whom resistance to fluoroquinolones and second-line injectable agents was excluded or is considered highly unlikely, a shorter MDR-TB regimen of 9–12 months may be used instead of the longer regimens (conditional recommendation, very low certainty in the ...
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 ]
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]
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.
Specifically it is used to treat active drug resistant tuberculosis together with other antituberculosis medications. [3] It has also been used as a second line agent to sulfasalazine in people with inflammatory bowel disease such as ulcerative colitis and Crohn's disease. [3] It is typically taken by mouth. [3]
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.