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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]
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 ]
Bedaquiline, sold under the brand name Sirturo, is a medication used for the treatment of active tuberculosis. [1] Specifically, it is used to treat multi-drug-resistant tuberculosis along with other medications for tuberculosis.
57 countries reported outcomes for patients started on extreme-drug resistant TB, this included 9258 patients. 39% completed treatment successfully, 26% of patients died and treatment failed for 18%. 84% of the extreme drug resistant cohort was made up of only three countries; India, Russian Federation and Ukraine.
An illustrative diagram explaining drug resistance. Drug resistance is the reduction in effectiveness of a medication such as an antimicrobial or an antineoplastic in treating a disease or condition. [1] The term is used in the context of resistance that pathogens or cancers have "acquired", that is, resistance has evolved.
Recognizing different degrees of MDR in bacteria, the terms extensively drug-resistant (XDR) and pandrug-resistant (PDR) have been introduced. Extensively drug-resistant (XDR) is the non-susceptibility of one bacteria species to all antimicrobial agents except in two or less antimicrobial categories.
Thioridazine is known to kill extensively drug-resistant tuberculosis [24] [25] and to make methicillin-resistant Staphylococcus aureus sensitive to β-lactam antibiotics. [26] [27] A possible mechanism of action for the drug's antibiotic activity is via the inhibition of bacterial secretion pumps.
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.