Kaul G, Kapoor E, Dasgupta A, Chopra S
Division of Microbiology, CSIR-Central Drug Research Institute, Lucknow, India.
Drugs Today (Barc). 2019 Mar;55(3):215-224. doi: 10.1358/dot.2019.55.3.2927587.
The spread of drug-resistant tuberculosis (TB) continues to be a global health crisis with increasing cases of multidrug-resistant TB (MDR-TB) being diagnosed worldwide. The identification and clinical management of MDR-TB is associated with additional problems related to resistance, diagnosis and treatment as compared to drug-susceptible TB. Treatment of MDR-TB usually involves therapy with long regimens of second-line drugs up to 24 months resulting in higher risks of serious adverse effects, lack of compliance and heightened economic burden on the patients. Issues such as increasing transmission of drug-resistant strains, poor diagnostic coverage and lengthy, toxic treatments need to be overcome by innovative approaches such as quick diagnostic tools and shorter drug regimens as already recommended by the World Health Organization (WHO) in its 2018 Global Tuberculosis Report. This review highlights the challenges being faced by clinicians worldwide in the diagnosis and treatment of MDR-TB.
耐药结核病（TB）的传播仍是一场全球健康危机，全球范围内多药耐药结核病（MDR-TB）的诊断病例不断增加。与药物敏感结核病相比，MDR-TB的识别和临床管理还存在与耐药性、诊断和治疗相关的其他问题。MDR-TB的治疗通常需要长达24个月的二线药物长期治疗方案，这会导致严重不良反应风险更高、患者依从性差以及经济负担加重。耐药菌株传播增加、诊断覆盖率低以及治疗时间长且有毒等问题，需要通过创新方法来克服，如世界卫生组织（WHO）在其《2018年全球结核病报告》中已经推荐的快速诊断工具和更短的药物治疗方案。本综述强调了全球临床医生在MDR-TB诊断和治疗中面临的挑战。
