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Extensively drug-resistant tuberculosis (XDR-TB) is a form of tuberculosis caused by bacteria that are resistant to some of the most effective anti-TB drugs. XDR-TB strains have arisen after the mismanagement of individuals with multidrug-resistant TB (MDR-TB). Almost one in four people in the world is infected with TB bacteria. [1]
There are several ways that drug resistance to TB, and drug resistance in general, can be prevented: [34] [35] Rapid diagnosis & treatment of TB: One of the greatest risk factors for drug-resistant TB is problems in treatment and diagnosis, especially in developing countries. If TB is identified and treated soon, drug resistance can be avoided.
As of October 2006, "Extensively drug-resistant tuberculosis" (XDR-TB) is defined as MDR-TB that is resistant to quinolones and also to any one of kanamycin, capreomycin, or amikacin. [76] The old case definition of XDR-TB is MDR-TB that is also resistant to three or more of the six classes of second-line drugs. [ 77 ]
Extensively drug-resistant TB is also resistant to three or more of the six classes of second-line drugs. [155] Totally drug-resistant TB is resistant to all currently used drugs. [ 156 ] It was first observed in 2003 in Italy, [ 157 ] but not widely reported until 2012, [ 156 ] [ 158 ] and has also been found in Iran and India. [ 159 ]
Extensively drug-resistant (XDR) is the non-susceptibility of one bacteria species to all antimicrobial agents except in two or less antimicrobial categories. Within XDR, pandrug-resistant (PDR) is the non-susceptibility of bacteria to all antimicrobial agents in all antimicrobial categories. [ 1 ]
Totally drug-resistant tuberculosis (TDR-TB) is a generic term for tuberculosis strains that are resistant to a wider range of drugs than strains classified as extensively drug-resistant tuberculosis. Extensively drug resistant tuberculosis is tuberculosis that is resistant to isoniazid and rifampicin, any fluoroquinolone, and any of the three ...
Mycobacterial resistance to rifampicin may occur alone or along with resistance to other first-line antitubercular drugs. Early detection of such multidrug or extensively drug-resistant tuberculosis is critical in improving patient outcomes by instituting appropriate second-line treatments, and in decreasing transmission of drug-resistant TB. [54]
The US Food and Drug Administration (FDA) approved pretomanid only in combination with bedaquiline and linezolid for treatment of a limited and specific population of adults with extensively drug resistant, treatment-intolerant or nonresponsive multidrug resistant pulmonary tuberculosis.