Medicine to treat Multi Drug Resistance in Tuberculosis ?

In India treatment of tuberculosis is Direct Observed Treatment Shortcourse or DOTS provided free at goverment hospital and health centres.

but if a patient leave a particular drug in the middle of treatment his body will develop resistance to that particular drug and his treatment become more difficult, long and expensive.

many are illetrate people who don"t understand what treatment, ressistance is and they leave the treatment as and when they recover from the first stage of treatment.

i think it is same with Anti Retro Viral drugs in treatment of HIV/AIDS.

When can one expect drugs to be available to treat M.D.R. in both the infectious and communicable diseases.

The treatment would be better knowledge given to the people. The need to be better informed of the dangers of not taking all their medication. Maybe even scared a little. Say," You must finish all your medication, even if you feel better before it's gone. If you don't you will die." It's a little harsh, but if that's what it takes to get the message across.

These medicines are called as second line treatment .But if facilities permits one should start them after culture &sensivity test .The name of medicines are;
1Inj a.Kannamycine b.Capreomycine .c injectable quinololes( ciproflox ;gatiflox;levoflox moxiflox etc.)
2 Ehoniamide 3 Protianamide 4 PAS 5 Oral Quinololes(names already mentioned in injectable range) 6 Cyclocerine 7Amikacine injection
one must be carefull about side effectes of these drugs mainly on Liver &Kideny .Treating specialist usualy know all of them & patient should also be told about some of main side effect symtomes so he can consult his Doctor timely.

Hi.
The best way is to make sure that these people never leave the 1st combination of therapy.
If they are being dorectly observed with DOTS then its more important to enforce the DOT than the 2 line drugs.
These drugs are extremely expensive and could put a big strain on the whole government.
They also have a series of adverse reactions that are very fatal.

Some of the drugs used though are
quinolones
ethionamide
amikacin, kanamycin
capreomycin


When trating MDR you should enforce the following.
1. Drug resistance may be suspected on the basis of historical ( previous treatment) or epidemiological (contact with a known drug resistant case, or coming from a region where MDR is common.)

2. Presence of drug resistance established by confirmed drug susceptibility testing.

3. An expert should be contacted and should be consulted during the period of treatment.

4. Consider the following expanded framework for the development of a regimen for MDR.
---INH, RIF, PZA, EMB, plus 3 additional agents based on the probability of invitro susceptibility ( eg Floroquinollones, ethionamide, amikacin, kanamycin, or capreomycin)

5. A single new drug should never be added to the failing regimen

MDR is a complex problem, wherein the infectous organism turns resistant to one drug after the other by undergoing genetic change. Research is going on addressing the pharmacogenetic aspect of the disease pathogenesis. Treatment doesnt seema long way to go.