Drug-resistant tuberculosis: Difference between revisions

Revision as of 13:58, 18 November 2022

Mycobacterium tuberculosis infection that is resistant to both first-line drugs, isoniazid and rifampin

Multidrug resistant tuberculosis (MDR-TB): resistance to isoniazid and rifampicin
Extensively drug-resistant tuberculosis (XDR-TB): resistance to at least isoniazid and rifampicin, and to any fluoroquinolone, and to any of the three second-line injectables
Totally drug-resistant tuberculosis (TDR-TB): not well-defined

8 months of an intensive four-drug regimen that includes any four drugs to which it is susceptible, in order of preference:
- Any first-line agents to which it is still susceptible
- A fluoroquinolone (except ciprofloxacin)
- An injectable: kanamycin, or other parenteral agent
- Other second-line agents, starting with ethionamide
Followed by 12 months of a less intensive regimen (at least three effective drugs), for a total of at least 20 months

Resistance To	Drug to Stop	Drug to Add	Regimen	Total Duration
INH	INH	FQN	6 months RMP+EMB+PZA+FQN	6 months from date FQN started
INH	INH	FQN	2 months RMP+EMB+PZA+FQN then 4 months RMP+EMB+FQN	6 months from date FQN started
RMP	RMP	FQN	2 months daily INH+EMB+PZA+FQN then 10-16 months INH+EMB+FQN	18 months from date FQN started
RMP	RMP	None	2 months INH+EMB+PZA, then 16 months INH+EMB	18 months from date FQN started
EMB	EMB	None	2 months INH+RMP+PZA, then 4 months INH+RMP	6 months from start of therapy
PZA	PZA	None	2 months INH+RMP+EMB, then 7 months INH+RMP	9 months from start of therapy
INH+EMB	INH+EMB	FQN	6 months daily RMP+PZA+FQN	6 months from date FQN started
INH+PZA	INH+PZA	FQN	9 months RMP+EMB+FQN	9 months from date FQN started
INH+EMB+PZA	INH+EMB+PZA	FQN+injectable	2 months TMP+FQN+injectable, then 7 months RMP+FQN	9 months from date FQN started

@@ Line 13: / Line 13: @@
 ** Other second-line agents, starting with ethionamide
 * Followed by 12 months of a less intensive regimen (at least three effective drugs), for a total of at least 20 months
+*
+{| class="wikitable"
+!Resistance To
+!Drug to Stop
+!Drug to Add
+!Regimen
+!Total Duration
+|-
+|INH
+|INH
+|FQN
+|6 months RMP+EMB+PZA+FQN
+|6 months from date FQN started
+|-
+|INH
+|INH
+|FQN
+|2 months RMP+EMB+PZA+FQN then 4 months RMP+EMB+FQN
+|6 months from date FQN started
+|-
+|RMP
+|RMP
+|FQN
+|2 months daily INH+EMB+PZA+FQN then 10-16 months INH+EMB+FQN
+|18 months from date FQN started
+|-
+|RMP
+|RMP
+|None
+|2 months INH+EMB+PZA, then 16 months INH+EMB
+|18 months from date FQN started
+|-
+|EMB
+|EMB
+|None
+|2 months INH+RMP+PZA, then 4 months INH+RMP
+|6 months from start of therapy
+|-
+|PZA
+|PZA
+|None
+|2 months INH+RMP+EMB, then 7 months INH+RMP
+|9 months from start of therapy
+|-
+|INH+EMB
+|INH+EMB
+|FQN
+|6 months daily RMP+PZA+FQN
+|6 months from date FQN started
+|-
+|INH+PZA
+|INH+PZA
+|FQN
+|9 months RMP+EMB+FQN
+|9 months from date FQN started
+|-
+|INH+EMB+PZA
+|INH+EMB+PZA
+|FQN+injectable
+|2 months TMP+FQN+injectable, then 7 months RMP+FQN
+|9 months from date FQN started
+|}
+*
 [[Category:Tuberculosis]]