Multidrug resistance in the world: the present situation

Area of Science:

• Medicine
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) remains a leading infectious cause of death globally, with one-third of the world's population infected.
• While TB rates have declined in the USA, multidrug-resistant TB (MDR-TB) is a significant challenge, exacerbated by HIV co-infection.
• MDR-TB emergence is linked to healthcare system failures, HIV epidemics, and inadequate treatment practices worldwide.

Purpose of the Study:

• To highlight the critical issue of multidrug-resistant tuberculosis (MDR-TB).
• To discuss the factors contributing to the rise of MDR-TB, particularly in the context of HIV co-infection.
• To emphasize essential therapeutic principles for managing TB and MDR-TB.

Main Methods:

• Analysis of TB and MDR-TB prevalence and contributing factors.
• Review of therapeutic guidelines and challenges in TB treatment.
• Examination of drug resistance patterns, including specific data from a 1991 US survey.

Main Results:

• A 1991 US survey indicated 3.5% of TB strains were resistant to isoniazid and rifampin.
• MDR-TB is prevalent globally due to healthcare breakdowns, improper prescriptions, and bioavailability issues.
• HIV epidemic accelerates active TB and the emergence of MDR-TB.

Conclusions:

• Effective management of TB and MDR-TB necessitates susceptibility testing and a complete drug history.
• Treatment requires an adequate number of effective drugs, avoiding the addition of single drugs to failing regimens.
• Addressing healthcare infrastructure and appropriate prescribing is crucial to combat MDR-TB.