MDR-TB Treatment & Prevention
Elimination of Cat 2 as first line treatment
Hi Carol,
Thanks for sharing this article, really.
Coming from the HIV and Infectious Diseases background, I must confess that I never understood the rationale for Cat 2 (with a recurrent question whether I am not a genuine isolated case...); in the management of other IDs, if there is a recurrence after a success treatment for a same presentation, unless severe condition, I usually attempt the treatment that had been successful, look for risk factors for recurrence or underlying conditions that can explain the recurrence; in the North, sure, we would do drug sensitivity testing concurrently, but no way we would just add one single drug and extend the treatment: there is a risk that the pathogenic agent is resistant to one or more of the first treatment drugs; while awaiting results, adding one drug to a regimen for which we do not know yet the efficacy,I would take 2 risks: one being sublevel antibiotic pressure, and as a result the second one being developing resistance to the added drug. May be someone can explan to me the rationale behind cat 2 which I also find even more irrational after failure or default.
Was cat 2 promoted to delay the costly identification, diagnosis and treatment of DRTB in a public health point of view.
I am being a bit provocative but honestly I do not know how many patients did not make it because I treated them with Cat 2???
I would appreciate your thoughts about this.
Thanks and Happy New Year to all.
Dr Francoise Nywagi Louis
Regional TBHIV Technical Advisor
National Expansion Coordinator for the Eastern Cape (USAID TB project in SA)
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