Tüberküloz Tedavisinde Direnç Sorunu: Tanrmlar ve Öneriler

Tüberküloz tedavisinde ilaç direnci, özellikle hastalığın dünya üzerinde yayılımını arttırıcı etkisinden dolayı büyük öneme sahiptir. Tedavide sorun oluşturan dirençler, özellikle çok ilaca direnç (MOR) ya da yaygın ilaç direnci (XDR) olarak tanımlanmaktadır. ikinci sınıf ilaçlar için geniş duyarlılık testlerinin yapılabildiği, bu ilaçların temin edilebildiği ve özellikle yatırılarak tedavi koşullarının sağlandığı durumların dirençli TB ile mücadelede anahtar önemi vardır.
Anahtar Kelimeler:

Tüberküloz, Direnç

Resistance Issue In Tuberculosis: Definitions And Suggestions

Resistance in tuberculosis treatment is a major concem especially because of its effect on increasing the spread of disease worldwide. The challenging resistances in the treatment are described as multi drug resistance (MDR) and extensively drug resistance (XDR). Conditions like being abi e to perform resistance assays for second line drugs, provide these drugs and inpatient treatment conditions have key-like importance at the management of tuberculosis resistance.

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  • Treatment of tuberculosis. American Thoracic Society, CDC, and Infectious Diseases Society of America. MMWR. Recommendation and Reports. June 20, 2003 / 52(RR11);1-77.
  • Mandeep J, William RB. Extensively drug-resistant tuberculosis. Lancet Infect Dis 2009;9:19- 30.
  • O'Brien RJ, Nunn PP. The need for new drugs against tuberculosis: obstacles, opportunities, and next steps. Am J Respir Crit Care Med 2001;163:1055—1058.
  • World Health Organisation.“WHO Global Task Force outlines measures to combat XDR-TB worldwide”. Retrieved on 2006-10-21.
  • Multidrug Resistant Tuberculosis, CDC , october 2008. www.cdc.gov/tb.
  • Eker B, Ortmann J, Migliori GB, et al. Multidrug and Extensively Drug Resistant Tuberculosis, Germany. Emerging Infectious Diseases 2008;14(11):1700-1706.
  • Migliori GB, Ortmann J, Girardi E, et al. Extensively drug-resistant tuberculosis,Italy and Germany. Emerging Infectious Diseases 2007;13:780-782.
  • World Health Organisation. Anti-tuberculosis drug resistance in the world, WHO Report No 3. Geneva: World Health Organisation, 2004.
  • Globe M, Iseman MD. Madsen LA, et al. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med 1993;328:527–32.
  • Pablo-Me´ndez A, Raviglione MC, Laszlo A, et al. Global surveillance for antituberculosis- drug resistance, 1994–1997. N Engl J Med1998;338:1641–9.
  • Schwoebel V, Decludt B, de Benoist A-C, et al. Multidrug resistant tuberculosis in France 1992–4: two case-control studies. BMJ 1998;317:630–1.
  • Espinal MA, Laszlo A, Simonsen L, et al. Global trends in resistance to antituberculosis drugs. N Engl J Med 2001;344:1294–303.
  • Pablo-Me´ndez A, Raviglione MC, Laszlo A, et al. Global surveillance for antituberculosis- drug resistance, 1994–1997. N Engl J Med 1998;338:1641–9.
  • McCray E, Onorato IM. The interaction of human immunodeficiency virus and multidrug- resistant Mycobacterium tuberculosis. In:Bastian I, Portaels F. Multidrug-resistant tuberculosis. Netherlands: Kluwer Academic Publishers, 2000:45–57.
  • Faustini A, Hall A J, Perucci C A. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax. 2006;61:158-63.
  • Granich R M, Oh P, Lewis B, Porco T C, Flood J. Multidrug Resistance Among Persons with Tuberculosis in California, 1994-2003. JAMA. 2005;293(22):2732-9.
  • Otkun M. Tüberküloz tedavisinde temel ilkeler ve direnç sorunu. Klimik Dergisi 2001;14 (2):71-82.
  • Pomerantz BJ, Clevelant JC, Jr, Olson HK. Pulmonary resection for multi-drug resistant tuberculosis. J Thorac Cardiovasc Surg 2001;121:448-453.
  • Nnoaham EK and Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. International Journal of Epidemiology 2008;37:113–119.
Arşiv Kaynak Tarama Dergisi-Cover
  • ISSN: 1300-3755
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1992
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi