Multidrug and extensively drug-resistant tuberculosis from a general practice perspective

Yashodhara, BM; Huat, Choo Beng; Naik, Lakshmi Nagappa; Umakanth, Shashikiran; Hande, Manjunath; Pappachan, Joseph M

doi:10.2147/idr.s10743

Cited by 4 publications

(2 citation statements)

References 31 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Isoniazid monoresistance being treated as drug-sensitive TB may lead to emergence and progression to MDR TB ( Pinto & Menzies, 2011 ; Yashodhara et al, 2010 ). The clinical treatment guidelines for isoniazid monoresistance is still empirical and yet to be evidence-based ( Pinto & Menzies, 2011 ; Yoshiyama et al, 2001 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Anuwatnonthakate

Whitehead

Varma³

et al. 2013

GJHS

View full text Add to dashboard Cite

Background:Drug resistance substantially increases tuberculosis (TB) mortality. This study aimed to describe the prevalence of mycobacterial drug resistance pattern and association of common resistance patterns with TB mortality in Thailand.Method:A retrospective cohort study was conducted using TB surveillance data. A total of 9,518 culture-confirmed, pulmonary TB patients registered from 1 October 2004 to 31 December 2008 from the Thailand TB Active Surveillance Network were included in this study. Patients were followed up until TB treatment completion or death. Mycobacterial drug resistance patterns were categorized as pan-susceptible, rifampicin resistance, isoniazid monoresistance, and ethambutol/streptomycin resistance. Drug susceptibility testing (DST) was determined by Mycobacterial Growth Indicator Tube (MGIT) liquid culture systems. Survival analysis was applied.Result:Isoniazid monoresistance was the most common pattern, while rifampicin resistance had the largest impact on mortality. Cox regression analysis showed a significantly higher risk of death among patients with rifampicin resistance (adjusted hazard ratio (aHR) 1.9, 95% confident interval (CI), 1.5-2.5) and isoniazid monoresistance (aHR 1.4, 95% CI 1.1-1.7) than those with pan-susceptible group after adjustment for age, nationality, human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status, diabetes mellitus, cavitary disease on chest x-ray, treatment observation, and province. HIV co-infection was associated with higher mortality in patients both on ART (aHR 1.9, 95% CI 1.5-2.5) and not on ART (aHR 8.1, 95% CI 6.8-9.8).Conclusion:Rifampicin resistance and isoniazid monoresistance were associated with increased TB mortality. HIV-coinfection was associated with a higher risk of death including among those taking antiretroviral therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Anuwatnonthakate

Whitehead

Varma³

et al. 2013

GJHS

View full text Add to dashboard Cite

show abstract

“… 9 The main source cases for community-level DR-TB transmission include those patients with DR-TB who are missed or late to be detected or TB cases who are not receiving effective and adequate treatment. 8 , 10 Despite this, the chance of developing wild-type RR/MDR-TB is extremely unusual to date as primary MDR/RR-TB is up-surging in the general community. This praised incidence of primary RR/MDR-TB amplifies the rate of ongoing person-to-person transmission of primary RR/MDR-TB in the community.…”

Section: Introductionmentioning

confidence: 99%

Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study

Kassa

Merid

Muluneh

2021

IDR

View full text Add to dashboard Cite

Background Rifampicin and/or multidrug-resistant tuberculosis (RR/MDR-TB) remains an uncontrolled public health emergency that has been synergized by the recently increased person-to-person transmission in the community as primary RR/MDR-TB, which is defined as RR/MDR-TB in new TB patients with no prior exposure to anti-TB treatment for more than one month. This study aimed to measure the prevalence and associated factors of primary drug-resistance among drug-resistant tuberculosis patients, as evidenced by the Amhara region treatment initiating centers. Methods An institutional-based multicenter cross-sectional study was conducted from September 2010 to December 2017, among 580 RR/MDR-TB patients on the second-line anti-TB drug in the Amhara regional state. Data were collected from patient charts and registration books using a standardized data abstraction sheet. The data were entered using Epi-data 4.2.0.0 and transferred to Stata 14 software for further data management and analysis. A bivariable and multivariable binary logistic model was run subsequently, and finally, a p-value of less than 0.05 with a 95% confidence interval (CI) was used to declare the significance of the explanatory variable. Results The magnitude of primary drug resistance among drug-resistant tuberculosis patients was 15.69% (95% CI: 12.94, 18.89). Alcohol drinking (adjusted odds ratio [AOR] = 0.31, 95% CI: 0.12–0.82), khat chewing (AOR = 4.43; 95% CI: 1.67–11.76), ambulatory and bedridden functional status (AOR = 0.43; 95% CI: 0.24–0.76) and (AOR = 0.41; 95% CI: 0.19–0.91), respectively, positive sputum smear result (AOR = 0.48; 95% CI: 0.26–0.90), and HIV coinfection (AOR= 2.31; 95% CI: 1.31–4.06) remained statistically significant associated factors of primary RR/MDR-TB. Conclusion Primary drug resistance is a public health problem in the study setting. Different behavioral and clinical conditions were significant factors of primary drug-resistant development. Mitigation strategies targeted on the patient’s clinical condition, substance-related behaviors, and universal DST coverage might be very important for early detection and treatment of RR/MDR-TB to prevent community-level transmission.

show abstract

Drug-Resistant Tuberculosis: Recent Approach in Polymer Based Nanomedicine

Shaji

Shaikh

2016

Int J Pharm Pharm Sci

View full text Add to dashboard Cite

Tuberculosis (TB) had been a leading chronic bacterial infection since decades. Current therapeutic management of Mycobacterium tuberculosis (MTB) is inadequate due to the lengthy course of treatment, drug-related side effects and ill-planned therapy, and these factors can lead to therapeutic failure and the emergence of drug-resistant TB. The Multi-drug-resistant (MDR) TB needs a lengthy course of treatment with secondline antitubercular drugs (ATDs) having higher side effects and cost. The misuse of second-line ATDs may result in extremely drug-resistant (XDR) strain which is very difficult to treat and require high doses of drugs resulting in more toxicity and side effects. This review highlights the need for novel drug delivery for the treatment of drug-susceptible and resistant TB. The characteristics of the nanoparticulate system in ATDs delivery and its approach in the MDR and XDR TB are discussed. The lung is the site of infection in pulmonary TB and the targeted drug delivery to the site of infection helps in achieving increased efficacy with less dose further reducing the side effects and toxicity. The symbiotic association of nanotechnology and pulmonary drug delivery give rise to an efficient inhalable polymer based nanoparticulate system containing ATDs for the better management of drug-susceptible and resistant TB. Various ATDs loaded polymer based nanocarrier systems like Alginate, PLGA, Chitosan and Gelatin nanocarriers are discussed in detail. Thus, this review highlights the current research in pulmonary drug delivery of polymer based ATDs nanomedicine and their importance in control of drug-resistant TB.

show abstract

Multidrug and extensively drug-resistant tuberculosis from a general practice perspective

Cited by 4 publications

References 31 publications

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study

Drug-Resistant Tuberculosis: Recent Approach in Polymer Based Nanomedicine

Contact Info

Product

Resources

About