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Updated: Aug 8, 2025
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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
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Management of Polydrug-Resistant Tuberculosis
Mediha Gonenc Ortakoylu1, Isil Kibar Akilli2, Lutfiye Kilic3
1Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences Turkey, Istanbul 34020, Turkey.
Medicina (Kaunas, Lithuania)
|February 25, 2023
Summary
Treatment for polydrug-resistant tuberculosis (TB) with isoniazid resistance requires individualized regimens. Fluoroquinolone or pyrazinamide resistance necessitates careful management and monitoring for successful outcomes.
Area of Science:
- Tuberculosis Research
- Antimicrobial Resistance
- Clinical Infectious Diseases
Background:
- Limited data exists on optimal treatment durations for multidrug-resistant tuberculosis (MDR-TB) with co-occurring isoniazid resistance and fluoroquinolone (FQ) or pyrazinamide (Z) resistance.
- Management of MDR-TB with complex resistance patterns requires specialized centers and tailored therapeutic strategies.
- Understanding acquired resistance mechanisms is crucial for effective TB treatment protocols.
Observation:
- A retrospective analysis of seven patients with polydrug-resistant TB, including isoniazid (H) resistance, was conducted.
- Resistance patterns observed included H+Z resistance (3 patients), H+FQ resistance (2 patients), and H+Z+FQ resistance (2 patients).
- Treatment involved a minimum of four drugs in the intensive phase and three in the continuation phase, with a total duration of 9-12 months.
Findings:
- Of the five patients followed, three completed treatment and two were cured, with no recurrence in the first year.
- Amikacin was associated with the most common and serious adverse drug effects.
- Treatment success hinges on individualized regimens based on drug susceptibility testing, clinical status, and disease extent.
Implications:
- For patients with H resistance and additional Z and/or FQ resistance, treatment must be individualized.
- Close monitoring of drug side effects is essential to improve treatment success rates in complex TB cases.
- Case-by-case management, considering resistance patterns and patient condition, is vital for effective MDR-TB therapy.
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