Format

Send to

Choose Destination
J Intern Med. 2018 May 28. doi: 10.1111/joim.12780. [Epub ahead of print]

Perspectives for personalized therapy for patients with multidrug-resistant tuberculosis.

Author information

1
Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
2
Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany.
3
International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany.
4
Department of Medicine, Karolinska Institute, Stockholm, Sweden.
5
Department of Pharmacotherapy and Translational Research, Infectious Disease Pharmacokinetics Laboratory, College of Pharmacy, University of Florida, Gainesville, FL, USA.
6
Department of Medicine, Center for Infectious Medicine (CIM), Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
7
Task Applied Science, Bellville, South Africa.
8
Division of Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
9
Section of Global and Immigrant Health, Baylor College of Medicine, Houston, TX, USA.
10
Department of Pumonary Diseases & Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
11
Molecular and Experimental Mycobacteriology, National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany.
12
Cellular Microbiology, Research Center Borstel, Borstel, Germany.
13
Biochemical Microbiology & Immunochemistry, University of Lübeck, Lübeck, Germany.
14
LRA INFECTIONS'21, Borstel, Germany.
15
Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
16
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
17
Department of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Linköping University, Linköping, Sweden.

Abstract

According to the World Health Organization (WHO), tuberculosis is the leading cause of death attributed to a single microbial pathogen worldwide. In addition to the large number of patients affected by tuberculosis, the emergence of Mycobacterium tuberculosis drug-resistance is complicating tuberculosis control in many high-burden countries. During the past 5 years, the global number of patients identified with multidrug-resistant tuberculosis (MDR-TB), defined as bacillary resistance at least against rifampicin and isoniazid, the two most active drugs in a treatment regimen, has increased by more than 20% annually. Today we experience a historical peak in the number of patients affected by MDR-TB. The management of MDR-TB is characterized by delayed diagnosis, uncertainty of the extent of bacillary drug-resistance, imprecise standardized drug regimens and dosages, very long duration of therapy and high frequency of adverse events which all translate into a poor prognosis for many of the affected patients. Major scientific and technological advances in recent years provide new perspectives through treatment regimens tailor-made to individual needs. Where available, such personalized treatment has major implications on the treatment outcomes of patients with MDR-TB. The challenge now is to bring these adances to those patients that need them most.

KEYWORDS:

MDR-TB; XDR-TB; individualized medicine; personalized medicine

PMID:
29806961
DOI:
10.1111/joim.12780

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center