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Factors affecting successful treatment of drug-resistant TB

A summary of research published in PLOS One

A new study has shed light on why people with tuberculosis (TB) may not complete the full course of their medication.

TB is one of the deadliest infectious diseases globally. There are strains of TB that are resistant to antibiotics — the medicine that is used to treat it. This is known as drug-resistant TB. This requires a much longer course of treatment than standard TB.

It is essential that people receiving treatment for TB take the full course of medicine they are given. This is so they have the best chance of recovering from the condition. It also helps reduce the chance of getting a drug-resistant form of the disease.

This study aimed to look at why people might miss doses of their medication, or stop it completely, when they are hospitalised with drug-resistant TB.

What did the study look at?

Researchers collected data on adults in South Africa with confirmed drug-resistant TB between 2008 and 2015. These people received treatment during a stay in specialist TB hospitals. Researchers looked at whether people took their medicine during this stay and the reasons why they might miss doses.

What do the results show?

Incomplete treatment was most likely with four specific drugs, compared to other drug-resistant TB drugs. The four drugs were: amikacin, capreomycin, para-aminosalicylic acid (PAS) and kanamycin.

These are all second-line anti-tuberculosis drugs. Second-line drugs are given after first-line drugs have been tried and failed. Second-line drugs tend to have more side-effects but are important treatments for drug-resistant TB. They are usually given by injection. The results of this study found that this group of drugs was most likely to be stopped because of their severe side effects.

Of all the drugs studied amikacin, PAS and ethionamide were the most likely to be stopped because of a person refusing to take them.

Why is this important?

It is important that healthcare professionals adopt the best way to treat people with drug-resistant TB. This is to give each person the best chance of recovery and to prevent the spread of TB. This study helps us to understand which drugs are linked with incomplete courses of treatment. It also looks at the reasons why.

The findings suggest that person-centred care, where an individual contributes to decisions about their care, could help improve treatment success. It also suggests that work needs to be done to improve the side effects linked with some TB drugs.

Read the original research paper: Variation in missed doses and reasons for discontinuation of anti-tuberculosis drugs during hospital treatment for drug-resistant tuberculosis in South Africa


World TB Day

World TB Day takes place on 24 March. It aims to raise awareness of the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global TB epidemic. Find out more:

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Watch the video of Tolibjon Karimov and Syovush Gardaliev talking about TB care during the pandemic.