Wednesday, April 7th, 2010

Multi Drug Resistant Tuberculosis

MDRTMulti Drug Resistant Tuberculosis (MDRT) is a scarier version of TB that needs prolonged treatment and is a major public health problem. It also threatens the success of DOTS, the WHO-recommended treatment approach for detection and cure of TB, as well as global tuberculosis control. DOTS—Directly Observed Treatment Short Course is a method of conquering TB. The basis of this program is to both treat and then monitor the TB infected subjects very closely, making sure they complete their course of antibiotics.

What is MDRT?

Dr R. K Maini, Director, Department of Pulmonogy at Artemis Health Institute says, “MDRT is defined as TB which is not responsive to the first line of treatment for the disease. It usually happens when the bug has been half treated or partially exposed to the drugs. Only pulmonary or lung TB patients are prone to develop MDRT.”
Causes

Non-compliance of the treatment—MDRT develops when the course of antibiotics is halted before completing the course of the medicine. Normally Anti-Tubercular-Medicines need to be taken for six to seven months. However, the patients may begin to feel better after some time of taking of medicines. If they halt the course of medicines then they allow the bacteria to become stronger and resistant to first line of antibiotics. It spreads from one person to another as readily as drug sensitive TB and in the same manner.

Improper use of medicines–This improper use is a result of a number of actions, including administration of improper treatment regimens

Treatment

Says Dr Maini, “Since these patients are resistant to first line of treatment second line of combination antibiotics are prescribed.” In order to gauge response to treatment repeated sputum cultures need to be done. The duration of the treatment is for a minimum of 18 months and it can’t be stopped until the patient’s sputum has tested culture negative for a minimum of 18 months. “Not only the duration of treatment is long, the medicines given are more potent with increased side effects and are expensive too,” warns Dr Maini. In extreme circumstances, surgery needs to be done to remove the infected portions of the lungs.

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