Treatment of Drug-Resistant Tuberculosis

Dear Colleagues,

Over the decades, the global fight against tuberculosis (TB) has repeatedly been compromised by drug-resistance (DR) amplification. Additive resistance to first-line drugs hinders a successful outcome in affected patients. The appearance of resistances has been associated with poor exposure to the drug at the site of infection, mainly due to inadequate adherence to treatment. To properly address the problem of drug resistance in TB a multidisciplinary effort is needed. The diagnosis of resistance has improved in the past few years, due to the implementation of molecular techniques, which have improved turnaround time and allowed the identification of patients at risk of drug-resistant TB. Despite being a very robust test for rifampicin resistance, molecular tests need further development to detect resistance to other TB drugs. Keeping this in mind, we can affirm that a phenotypic drug sensitivity test is a pivotal tool to tailor treatments for patients with DR TB. For designing a treatment for a patient with DR TB we need to take into account the previous use of TB drugs, comorbidities, concomitant medications, drug sensitivity tests, and drug availability and cost. The launching of new drugs and the repurposing of old drugs have increased our arsenal in the fight against TB. However, there is scarce evidence to support which is the best treatment for DR TB. Recent evidence has shown that quinolones and linezolid have the potential to circumvallate resistance to first-line drugs, although drug interaction and safety concerns may limit their use.

The Journal Medicina is presenting a Special Issue tackling the treatment of drug-resistant TB. The Special Issue will approach the broad field of treatment of drug resistance in tuberculosis from different points of view, including, but not limited to patient safety and efficacy, microbiological aspects, PK/PD, socioeconomic issues, perspectives from the patients, advances in research, current clinical trials, methodology innovations, implementation, and operational deployment. We want to give readers an integrative and edifying view of the topic. This Special Issue is open to original work, point of view articles, and reviews tackling DR TB.

Dr. Adrian-Sanchez Montalva
Guest Editor

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