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[Tuberculosis treatment in 2007].

¹Service des maladies infectieuses et réanimation médicale, CHU de Pontchaillou, rue Le Guilloux, 35033 Rennes cedex, France. pierre.tattevin@chu-rennes.fr

Medecine Et Maladies Infectieuses

|June 19, 2007

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Standard tuberculosis treatment involves a two-month initial phase with four drugs and a four-month continuation phase with two drugs. Recent data highlight challenges like drug resistance and new options for tuberculosis management.

Area of Science:

Infectious Diseases
Public Health
Pharmacology

Context:

Tuberculosis (TB) treatment guidelines have remained largely unchanged for three decades.
Established protocols include a two-month initial phase (isoniazid, rifampin, pyrazinamide, ethambutol) and a four-month continuation phase (isoniazid, rifampin).
Recent data necessitate a review of current TB management strategies.

Purpose:

To review and update tuberculosis treatment principles based on recent data.
To address the epidemiology of resistant tuberculosis, including multi-drug resistant (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).
To discuss advancements in latent tuberculosis diagnosis and treatment, neuromeningeal TB, and TB in HIV-infected patients.

Summary:

The review covers the epidemiology of resistant tuberculosis, emphasizing rising MDR-TB and XDR-TB.

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It addresses the standard of care for latent tuberculosis, including new diagnostics and prophylaxis before TNF inhibitors.

New therapeutic options for MDR-TB (moxifloxacin, linezolid), corticosteroids in neuromeningeal TB, and TB treatment in HIV patients are discussed.

Impact:

Highlights discrepancies between established guidelines and actual practices in France.
Provides insights into emerging challenges and therapeutic advancements in tuberculosis care.
Informs healthcare professionals on updated strategies for managing diverse tuberculosis cases, including resistant forms and co-infections.