Author/Authors :
Joia S Mukherjee، نويسنده , , Michael W. Rich، نويسنده , , Adrienne R Socci، نويسنده , , J Keith Joseph، نويسنده , , Felix Alc?ntara Vir?، نويسنده , , Sonya S Shin، نويسنده , , Jennifer J Furin، نويسنده , , Mercedes C Becerra، نويسنده , , Donna J Barry، نويسنده , , Jim Yong Kim، نويسنده , , Jaime Bayona، نويسنده , , Paul Farmer، نويسنده , , Mary C Smith Fawzi، نويسنده , , Kwonjune J Seung، نويسنده ,
Abstract :
Multidrug-resistant tuberculosis (MDR-TB) presents an increasing threat to global tuberculosis control. Many crucial management issues in MDR-TB treatment remain unanswered. We reviewed the existing scientific research on MDR-TB treatment, which consists entirely of retrospective cohort studies. Although direct comparisons of these studies are impossible, some insights can be gained: MDR-TB can and should be addressed therapeutically in resource-poor settings; starting of treatment early is crucial; aggressive treatment regimens and high-end dosing are recommended given the lower potency of second-line antituberculosis drugs; and strategies to improve treatment adherence, such as directly observed therapy, should be used. Opportunities to treat MDR-TB in developing countries are now possible through the Global Fund to Fight AIDS, TB, and Malaria, and the Green Light Committee for Access to Second-line Anti-tuberculosis Drugs. As treatment of MDR-TB becomes increasingly available in resource-poor areas, where it is needed most, further clinical and operational research is urgently needed to guide clinicians in the management of this disease.
