Among patients identified with pulmonary tuberculosis (TB) in 2011, an estimated 310,000 had multidrug-resistant (MDR)-TB (1). However, less than 20% of these patients were diagnosed and treated for MDR-TB (1). By definition, MDR-TB is resistant to the two most effective TB medicines. Consequently, patients require complex treatment comprised of multiple drugs for up to two years. These medicines are not only more expensive and less effective than the standard treatment for TB, but they are also associated with severe side effects, such as permanent hearing loss.
In an effort to promote optimal treatment for MDR-TB, the USAID-funded Systems for Improved Access to Services and Pharmaceuticals (SIAPS) project sponsored a symposium on Saturday, November 20 titled “Rational Drug Use for MDR-TB: start safe, stay safe, breathe safe.” TB medicine expert Dr. Jose Caminero and SIAPS Senior Technical Advisor Dr. Archil Salakaia facilitated discussion from a panel of TB specialists on how to design safe and effective MDR-TB treatment regimens. Presenters identified a number of challenges in administering MDR-TB treatment; for example, its long duration and high rates of side effects may prevent patients from completing their full treatment course. If patients stop medicine early, not only does their TB remain uncured but they also risk developing further resistance and spreading TB to others in the community.
To address this challenge and others, the symposium highlighted a number of useful approaches to prevent and manage MDR-TB, such as adherence to standard treatment guidelines, as well as the SIAPS tool “Guidelines for Conducting Drug Resistant Tuberculosis Drug Utilization Reviews”. At a time when new medicines are under development and treatment recommendations are changing alongside evolving evidence, the symposium served as an important opportunity to discuss resources available to help both providers and patients.
Citation:(1) Stop TB Partnership. Stop TB Working Group on MDR-TB. http://www.stoptb.org/wg/mdrtb/keyfacts.asp