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WHO new grouping of drugs for MDR / RR TB

By Prince James | 19 Aug, 2018

Administering multiple doses of Imipenem / Meropenem and their huge cost makes their application more difficult than Amikacin - which is placed lower than Imipenem in the new grouping of drugs.
Should not we still choose Amikacin over Imipenem in an MDR TB tt regimen?



jeetesh singh Replied at 3:33 AM, 19 Aug 2018

That’s a very important question

Stephen Muleshe Replied at 5:23 AM, 20 Aug 2018

Dear All
Very important observation. Imipenem/Meropenem will usually require a
chemopot for administration which most patients may not afford. We should
reconsider the order


Dr. Stephen K. Muleshe
Head, TB Care & Treatment
National TB, Leprosy and Lung Disease Program
Department of Preventive and Promotive Health
Ministry of Health | Afya Annex | KNH grounds
P.O. Box 20781-00202, Nairobi
Website: www.nltp.co.ke | Facebook: NTLDKenya | Twitter: @NTLDKenya

Lindsay McKenna Replied at 10:12 AM, 23 Aug 2018

Dear Dr. Muleshe,

Your point about challenges with the administration of imipenem/meropenem
is really important. There are enough medicines listed before you get to i
mipenem/meropenem and amikacin to build a regimen with 4–5 effective drugs
and so the focus should be building regimens with drugs from groups A and
B, and those listed earlier in group C, and hopefully only resorting to
those listed towards the end of group C in desperate situations.

dharm dwivedi Replied at 12:09 AM, 25 Aug 2018

it will be really difficult, especially major burden of the disease is in
resource-constrained countries

Yasir Waheed Replied at 3:49 AM, 27 Aug 2018

We know that the grouping is prioritized as choosing drugs from A then B & C but are the drugs in same group (e.g. group C) also prioritized in terms of selection order?

Erica Lessem Replied at 11:57 AM, 27 Aug 2018

I believe they are, Yasir

Subbalaxmi Malladi Replied at 1:21 PM, 27 Aug 2018

Administering for Tb in my view is not practical firstly due to cost secondly due to three times, IV infusions for months together.
dr subbalaxmi

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