@article {Lange:2019:1027-3719:645,
title = "Management of patients with multidrug-resistant tuberculosis",
journal = "The International Journal of Tuberculosis and Lung Disease",
parent_itemid = "infobike://iuatld/ijtld",
publishercode ="iuatld",
year = "2019",
volume = "23",
number = "6",
publication date ="2019-06-01T00:00:00",
pages = "645-662",
itemtype = "ARTICLE",
issn = "1027-3719",
eissn = "1815-7920",
url = "https://www.ingentaconnect.com/content/iuatld/ijtld/2019/00000023/00000006/art00003",
doi = "doi:10.5588/ijtld.18.0622",
keyword = "RESIST-TB, MDR-TB, XDR-TB, TBNET, TB, personalised treatment",
author = "Lange, C. and Aarnoutse, R. E. and Alffenaar, J. W. C. and Bothamley, G. and Brinkmann, F. and Costa, J. and Chesov, D. and van Crevel, R. and Dedicoat, M. and Dominguez, J. and Duarte, R. and Grobbel, H. P. and G{\"u}nther, G. and Guglielmetti, L. and Heyckendorf, J. and Kay, A. W. and Kirakosyan, O. and Kirk, O. and Koczulla, R. A. and Kudriashov, G. G. and Kuksa, L. and van Leth, F. and Magis-Escurra, C. and Mandalakas, A. M. and Molina-Moya, B. and Peloquin, C. A. and Reimann, M. and Rumetshofer, R. and Schaaf, H. S. and Sch{\"o}n, T. and Tiberi, S. and Valda, J. and Yablonskii, P. K. and Dheda, K.",
abstract = "The emergence of multidrug-resistant tuberculosis (MDR-TB; defined as resistance to at least rifampicin and isoniazid) represents a growing threat to public health and economic growth. Never before in the history of mankind have more patients been affected by MDR-TB than is the case
today. The World Health Organization reports that MDR-TB outcomes are poor despite staggeringly high management costs. Moreover, treatment is prolonged, adverse events are common, and the majority of affected patients do not receive adequate treatment. As MDR-TB strains are often resistant
to one or more second-line anti-TB drugs, in-depth genotypic and phenotypic drug susceptibility testing is needed to construct personalised treatment regimens to improve treatment outcomes. For the first time in decades, the availability of novel drugs such as bedaquiline allow us to design
potent and well-tolerated personalised MDR-TB treatment regimens based solely on oral drugs. In this article, we present management guidance to optimise the diagnosis, algorithm-based treatment, drug dosing and therapeutic drug monitoring, and the management of adverse events and comorbidities,
associated with MDR-TB. We also discuss the role of surgery, physiotherapy, rehabilitation, palliative care and smoking cessation in patients with MDR-TB. We hope that incorporating these recommendations into patient care will be helpful in optimising treatment outcomes, and lead to more MDR-TB
patients achieving a relapse-free cure.",
}