Biggest Global Health Threats of "Drug-Resistant Tuberculosis"

Drug Resistant Tuberculosis

DRTB is defined as a form of TB infection caused by bacterial stain resistant to Anti Tuberculosis Agent which used in its treatment.

Many cases of  Tuberculosis Disease can be cured with antibiotics treatment as First-line drugs which are :-

• Isoniazid
• Rifampicin
• Pyrazinamide
• Ethambutal
• Streptomycin

But TB bacterium resist to antibiotics are vary common which arise due to improper management or improper use of antibiotics in chemotherapy of Drug-Susceptible TB patient.This improper management means administration of improper treatment regimens &/or incomplete the course of treatment.This is called Drug-resistant Tuberculosis Disease (DRTB) which is very lethal to human being because it vary difficult to Doctor to cure this due to limited drugs are available. 

The medical aid organization Medecins Sans Frontieres/Doctors Without Borders  has published a briefing paper about the alarming spread of deadly strains of drug-resistant tuberculosis (DR-TB) is one of the biggest global health threats we face today. It calls on governments, pharmaceutical companies and researchers to mobilise urgently to save more lives and find new treatments to stem the virulent disease.

Every year, around eight million people worldwide fall ill with tuberculosis (TB) and 1.3 million people die from the infectious airborne disease.   In Ireland in 2013, 384 cases of TB were reported, representing on average one person being diagnosed with the disease every day.   TB is curable, but an inadequate global response has allowed drug-resistant TB to take a hold.

Around half a million new cases of Drug-resistant TB  occur every year and are reported in virtually all countries worldwide, with even harder to treat forms reported in nearly 100 countries. Now these deadlier DR-TB strains are spreading from person to person. Yet today, no matter where you live, there is no means to treat it effectively.

Now Tuberculosis bacterium become a more powerful bacteria due to its resistance power against antibiotics.If we are not to be alert about DRTB,the tuberculosis will gets untreatable. Therefore DRTB become a global health problem & we should proper guide to people that how protect to us against TB  & also guide to  Drug-Susceptible TB patient to complete the  exact course of treatment  to increase the chance of successful eradication of infection and to reduce the risk of antibiotic resistance developing.If normal person come in contact to DRTB patient then normal person directly receive to drug resistant bacterium. Therefore it is vary necessary to isolate the drug resistant TB patients from community because these patient do't affected to other person.

Types of Drug-Resistant Tuberculosis:

There are two main types of drug resistant TB:

1. Multi-Drug Resistant Tuberculosis (MDR TB)
2. Extensively-Drug Resistant Tuberculosis (XDR TB)

Another type of drug resistant TB is:-

• Total-Drug Resistant Tuberculosis (TDR TB)

Multi-Drug Resistant Tuberculosis (MDR TB):

MDR TB is the name given to TB when the bacteria (that are causing it) are resistant to at least two of the most powerful First-Line anti TB drugs,Isoniazid & Rifampicin.


Extensively-Drug Resistant Tuberculosis (XDR TB):

XDR TB is defined as strain resistant to at least Rifampicin & Isoniazid in addition to being resistant to one of the Fluoroquinolones  as well as resistant to at least one of the second line injection TB drugs Amikacin,Kanamycin or capreomycin.

TB drugs for the treatment of drug resistant TB:

For the treatment of drug resistant TB, the current TB drugs are grouped according their effectiveness, experience of use, and drug class, as shown below.

All the drugs in Groups 2 to 5, apart from streptomycin, are referred to as “second line” or reserve TB drugs.

The first four groups of TB drugs listed below, are those that are mainly used for the treatment of drug resistant TB. The fifth group of TB drugs are some drugs that are unknown in how effective they are in the treatment of TB, but they can be tried when there is no other option. An example is using them in the treatment of totally drug resistant TB. 

TB drugs used to treat drug resistant TB according to group (class)

Group 1 TB drugs : First Line Oral Agents-

                                        
                                       pyrazinamide

                                        ethambutol

                                        rifabutin

Group 2 TB drugs : Injectable Agents-

                                       
                                        kanamycin

                                        amikacin

                                        capreomycin

                                        streptomycin

Group 3 TB drugs : Fluoroquinolones-

                                        
                                        levofloxacin

                                        moxifloxacin

                                        ofloxacin

Group 4 TB drugs : Oral Bacteriostatic Second Line Agents-

                                        
                                        para–aminosalicylic acid

                                        cycloserine

                                        terizidone

                                        thionamide

                                        protionamide

Group 5 TB drugs: Agents with an unclear role in the treatment of drug                                                        

resistant TB -
                                       
                                       clofazimine

                                       linezolid

                                       amoxicillin/clavulanate

                                       thioacetazone

                                       imipenem/cilastatin

                                       high dose isoniazid

                                       clarithromycin