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The second-line drugs (WHO groups 2, 3, and 4) are only used to treat disease that is resistant to first line therapy (i.e., for extensively drug-resistant tuberculosis (XDR-TB) or multidrug-resistant tuberculosis (MDR-TB)).
Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications (drugs): isoniazid and rifampicin.
XDR-TB is defined as TB that has developed resistance to at least rifampicin and isoniazid (resistance to these first line anti-TB drugs defines multidrug-resistant tuberculosis, or MDR-TB), as well as to any member of the quinolone family and at least one of the following second-line anti-TB injectable drugs: kanamycin, capreomycin, or ...
MDR-TB is defined as resistance to the two most effective first-line TB drugs: rifampicin and isoniazid. 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]
Some strains of the tuberculosis pathogen are resistant to two (called MDR-TB) or at least four (called XDR-TB) first-line tuberculosis drugs. [13] Due to the contagious nature of tuberculosis, drug resistance is considered to be a serious public health issue, particularly among people with an already weakened immune system, for example people ...
Isoniazid and a related drug, iproniazid, were among the first drugs to be referred to as antidepressants. [20] Psychiatric use stopped in 1961 following reports of hepatotoxicity. Use against tuberculosis continued, as isoniazid's effectiveness against the disease outweighs its risks. [21]
(S,S)-(+)-Ethambutol is powerful and selective antitubercular drug.It is a typical example of an old drug that was introduced for clinical use in its unichiral form. . Ethambutol contains two constitutionally symmetrical chiral centers in its structure and exists in three stereoisomeric forms, the enantiomeric pair (+)-(S,S)- and (−)-(R,R)-ethambutol, along with the achiral stereoisomer called m
It is in the nitroimidazole class of medications. [6] Pretomanid was approved for medical use in the United States in August 2019, [4] [7] and in the European Union in July 2020. [2] Pretomanid was developed by TB Alliance. [8] [4] [9] The US Food and Drug Administration (FDA) considers it to be a first-in-class medication. [10]