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Infection caused by Mycobacterium tuberculosis

C A Peloquin1, S E Berning

  • 1Infectious Disease Pharmacokinetics Laboratory (IDPL), National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206.

The Annals of Pharmacotherapy
|January 1, 1994
PubMed
Summary

Tuberculosis (TB) is increasing in the US due to healthcare system failures and funding cuts, necessitating greater effort and funding for elimination. Treatment of drug-resistant TB is challenging, requiring longer durations and new agents for improved outcomes.

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Microbiology

Background:

  • The incidence of tuberculosis (TB) is rising in the United States, exacerbated by HIV coinfection.
  • Limited drug options and the emergence of multidrug-resistant TB (MDR-TB) pose significant treatment challenges.

Purpose of the Study:

  • To provide an update on the clinical management of Mycobacterium tuberculosis infections.
  • To describe the organism, diagnostic methods, clinical manifestations, and treatment strategies for TB.
  • To discuss historical perspectives, current approaches, and future research opportunities in TB treatment.

Main Methods:

  • A comprehensive review of current medical literature, including international meeting abstracts.
  • Data sourced from MEDLINE, MEDLARS II, Current Contents, and published meeting abstracts.

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  • Focus on clinical management of both noncontagious and active TB, with attention to MDR-TB.

    • Main Results:

    • Rising TB incidence in the US is linked to healthcare system breakdowns and reduced funding.
    • Treatment of MDR-TB is prolonged, toxic, and less successful than drug-susceptible TB.
    • Preventive therapy for MDR-TB exposure is controversial and of uncertain efficacy.

    Conclusions:

    • Eliminating TB in the US requires substantial increased effort and funding.
    • Treatment selection must be guided by drug susceptibility data, with prolonged multi-drug therapy (6-24 months) and verified patient adherence.
    • New agents are crucial for improving outcomes in MDR-TB, especially in coinfected patients with potential drug malabsorption.