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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?

Replies

 

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

Rgds

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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