Tuberculosis Products Unit, Otsuka Pharmaceutical Development and Commercialization, 2440 Research Boulevard, Rockville, MD, 20850, USA,
Curr Infect Dis Rep. 2010 May;12(3):192-7. doi: 10.1007/s11908-010-0104-5.
Multidrug-resistant (MDR) tuberculosis (TB), or TB caused by strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, represents a major threat to global TB control. Comprising more than 5% of all TB cases annually worldwide, these cases require treatment duration of 2 years on average with expensive and toxic second-line anti-TB drugs. Cure rates are far lower and mortality far higher than for drug-susceptible TB, particularly if patients are coinfected with HIV. Use of rapid diagnostic tools and assessment of risk factors for MDR TB, as well as rapid initiation of MDR TB treatment as recommended by the World Health Organization, including use of appropriate empiric regimens as necessary, is essential to achieving good outcomes from treatment. Rapid initiation of antiretroviral therapy (ART) for those with HIV coinfection, as well as strategic management of overlapping side effects from ART and first and second-line drugs for treating MDR TB to maintain patients on treatment are critical to patient survival and achieving good treatment outcomes. Employing sensible infection control practices in the context of diagnosis and treatment is essential to reducing transmission of MDR TB strains among patient populations and healthcare personnel.
耐多药结核病（MDR-TB），或由至少对异烟肼和利福平耐药的结核分枝杆菌菌株引起的结核病，是全球结核病控制的主要威胁。这些病例占全球每年所有结核病病例的 5%以上，平均需要 2 年的治疗时间，使用昂贵且有毒的二线抗结核药物。治愈率远低于耐多药结核病，死亡率也远高于耐多药结核病，特别是如果患者同时感染了 HIV。使用快速诊断工具和评估耐多药结核病的危险因素，以及按照世界卫生组织的建议尽快开始耐多药结核病治疗，包括在必要时使用适当的经验性治疗方案，对于治疗取得良好效果至关重要。对于合并 HIV 感染的患者，尽快开始抗逆转录病毒治疗（ART），以及战略性地管理重叠的 ART 和治疗耐多药结核病的一线和二线药物的副作用，以确保患者继续接受治疗，对于患者的生存和取得良好的治疗效果至关重要。在诊断和治疗过程中采取合理的感染控制措施，对于减少耐多药结核菌株在患者群体和医疗保健人员中的传播至关重要。
