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Inicio Medicina Clínica (English Edition) Multi-drug resistant tuberculosis, ten years later
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Vol. 156. Issue 8.
Pages 393-401 (April 2021)
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Vol. 156. Issue 8.
Pages 393-401 (April 2021)
Review
DOI: 10.1016/j.medcle.2020.08.009
Multi-drug resistant tuberculosis, ten years later
Tuberculosis multirresistente, diez años después
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José Antonio Caminero Luna
Corresponding author
jcamlun69@gmail.com

Corresponding author.
, Guillermo Pérez Mendoza, Felipe Rodríguez de Castro
Unidad de Tuberculosis y Micobacteriosis, Servicio de Neumología, Hospital General de Gran Canaria «Dr. Negrin», Las Palmas de Gran Canaria, Spain
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Tables (6)
Table 1. List of drugs with activity against Mycobacterium tuberculosis, presented in order of efficacy (1A) and according to recommended characteristics (1B).
Table 2. Drugs with activity against Mycobacterium tuberculosis available today. Route of administration, recommended dose, dispensing and most frequent adverse effects.
Table 3. Minimum requirements that any tuberculosis treatment regimen should meet.8,10,11.
Table 4. Treatment of tuberculosis according to resistance patterns.2,11.
Table 5. Classification of drugs with activity against Mycobacterium tuberculosis, according to the different resistance patterns.2,8,10.
Table 6. Basic recommendations for good clinical management of cases of tuberculosis and tuberculosis with drug resistance.2.
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Abstract

Drug-resistant tuberculosis, especially that with resistance to rifampicin (RR-TB), has become one of the main obstacles to achieving the dream of eradicating tuberculosis. Furthermore, it is necessary to combine 3 or 4 different drugs in the attempt to cure TB, however, unfortunately, there are few available that can be considered genuinely effective. Fortunately, the notable worldwide increase in RR-TB in recent years has led to the investment of resources in the development of new drugs for TB, and other drugs investigated for other diseases have been successfully tested on TB. This has resulted in a clear change in the clinical management of these patients over the last 3−4 years, and it is now easier to design therapeutic regimens and achieve higher success rates. All these changes are updated in this review.

Keywords:
Tuberculosis
Drug-resistant tuberculosis
Multi-drug resistant tuberculosis
MDR-TB
Extensively drug-resistant tuberculosis
XDR-TB
Treatment
Resumen

La tuberculosis con resistencia a fármacos, sobre todo la que conlleva resistencia a rifampicina (TB-RR), se ha convertido en uno de los principales obstáculos para alcanzar el sueño de erradicar esta enfermedad. Y es que, para intentar curar la TB es necesario asociar 3 o 4 fármacos diferentes y, lamentablemente, son pocos los disponibles que se puedan considerar auténticamente eficaces. Pero, afortunadamente, el notable incremento que ha habido en los últimos años de la TB-RR en el mundo, ha motivado que se hayan invertido recursos en el desarrollo de nuevos fármacos para la TB, o que otros antimicrobianos investigados para otras enfermedades se hayan probado con éxito en la TB. Esto ha hecho que el manejo clínico de estos pacientes haya cambiado notablemente en los últimos 3−4 años, y resulte ahora más sencillo diseñar esquemas terapéuticos y conseguir mayores tasas de éxito. Todos estos cambios se actualizan en esta revisión.

Palabras clave:
Tuberculosis
Tuberculosis con resistencia a fármacos
Tuberculosis multi-resistente
TB-MDR
TB extensamente fármaco resistente
TB-XDR
Tratamiento

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