In this community, professionals share information regarding the clinical, programmatic and community-oriented aspects of early diagnosis, treatment and prevention of multi-drug-resistant tuberculosis (MDR-TB). Members also use this forum to promote universal access to quality care for MDR-TB.
It seems like the first question at hand is “what is the differential diagnosis for hemoptysis?” in a patient with a recent history of treated MDR-TB. Hemoptysis is usually a symptom of erosion into a bronchial artery. In light of the patient’s history, the most concerning etiology would be relapse ... read more
Phenotypic DST for first-line agents (isoniazid and rifampicin), and selected second-line anti-TB drugs (kanamycin, amikacin, ofloxacin, levofloxacin) is generally reliable and reproducible across various settings. New drugs for the treatment of MDR-TB such as bedaquiline and delamanid are recommended for use by WHO under specific conditions and may be added ... read more
Pyrazinamide is a prodrug which in M. tuberculosis is converted to the active agent pyrazinoic acid by the enzyme pyrazinimidase (PZase). Absence of a functional PZase enzyme in M. tuberculosis indicates resistance to pyrazinamide (sensitivity 79-96%). Mutations associated with pncA gene are associated with a loss of PZase activity resulting ... read more
Understand totally what you have said. I do believe that it is useful to know that of the reported ADRs amikacin has more and capreomycin less relative ototoxicity. That said, the study gives no indication the relative ototoxicity of the various drugs and I think it is a shame to ... read more
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