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MDR & XDR Tuberculosis

MDR & XDR Tuberculosis

          
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About the Book

• Written with the aim of defining a practical approach to every aspect of drug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).
• Covers epidemiology, diagnosis and practical approach to the treatment of MDR and XDR-TB including HIV and DR-TB.
• Includes special chapter on case-based approach to the treatment of MDR-TB.
• Chapters on DR-TB in children, DR-TB in extrapulmonary tuberculosis, fluoroquinolone resistance, infection control in DR-TB and newer antituberculosis drugs are also included.
• Incorporates latest advances and references upto 2013.
• Practical guide to undergraduates, postgraduates, practitioners and program managers in TB control.

About the Author

Rajendra Prasad, MD,DTCD,FAMS,FCCP(USA),FNCCP,FCAI,FIAB,FIMSA,DSC



Table of Contents:
1. Case Definitions in Drug-resistant Tuberculosis 1 Treatment Outcomes in DOTS-PLUS 2 2. Antitubercular Drugs Used in Previously Treated Patients of Tuberculosis and their Adverse Effects 4 Kanamycin 4 Amikacin 12 Capreomycin 14Ethionamide and Prothionamide 16 Cycloserine 18 Para-aminosalicylic Acid (PAS) 20 Levofloxacin 22 Moxifloxacin 24 Ofloxacin 26 Clofazimine 27 Thiacetazone 29 Clarithromycin 30 Linezolid 31 Imipenem/Cilastatin 31 Amoxicillin Clavulanate 32 3. Management of Retreatment Cases in Tuberculosis 35 Relapse 35 Defaulters or Treatment after Default 36 Failure 36 Poor Adherence to Treatment 37 Drug Resistant Tuberculosis 37 Prevention of Retreatment Cases 43 4. Mono- and Poly-drug-resistant Tuberculosis: Current Status 47 Definition 47 Types of Drug Resistance 47 Prevalence of Mono- and Poly-drug Resistance: Global Scenario 48 Prevalence of Mono- and Poly-drug Resistance: India 50 Mechanism of Drug Resistance 52 HIV Infection and Drug-resistant Tuberculosis 52 Risk Factors of Mono- and Poly-drug Resistance 53 Sources and Causes of Mono- and Poly-drug Resistance 54 5. Mono- and Poly-drug-resistant Tuberculosis: Treatment 57 Impact of Mono- and Poly-drug Resistance on the Outcome of Chemotherapy 57 General Principles for Designing Treatment Regimen for Mono- and Poly-drug-resistant TB 58 Development of Further Resistance 60 6. Multi-drug-resistant Tuberculosis: Current Status 61 Definition 61 Types of Drug Resistance 61 Prevalence of MDR-TB: Global Scenario 62 Trends in MDR-TB: Global Scenario 65 Prevalence of MDR-TB: India 66 HIV Infection and Multi-drug-resistant Tuberculosis 69 Risk Factors of MDR-TB 71 Sources and Causes of MDR-TB 71 Control of MDR-TB 72 7. Multi-drug-resistant Tuberculosis: Case Finding Strategies 77 Targeting Risk Groups for Drug Susceptibility Test (DST) 77 Strategies for Programs with Minimal Access to DST and limited Resources 78 8. Multi-drug-resistant Tuberculosis: laboratory Issues 82 General Considerations 82 Essential laboratory Services and Infrastructure 83 Organization of the laboratory Network 83 Drug Susceptibility Testing (DST) 85 Limitations of DST 87 Rational use of DST in DR-TB Control Programs 87 Time for Testing and Reporting: Turnaround Time 88 Infection Control and Biosafety in the laboratory 88 Quality Control and Quality Assurance 89 9. Multi-drug-resistant Tuberculosis: Diagnosis and Treatment 92 Definition 92 Mechanism of Drug Resistance 92 Genetic Basis of Drug Resistance 93 Virulence and Drug-resistant Strains 93 Impact of Drug Resistance on the Outcome of Chemotherapy 93 Diagnosis of Multi-drug-resistant Tuberculosis 94 Treatment of Multi-drug-resistant Tuberculosis 98 Immunotherapy or Immunomodulation 105 Outcome of Treatment 106 10. Multi-drug-resistant Tuberculosis: Management in Special Situations 112 M/XDR-TB in Pregnancy 112 M/XDR-TB in Breastfeeding 113 M/XDR-TB in Contraception 114 M/XDR-TB in Children 114 M/XDR-TB in Diabetes Mellitus 115 M/XDR-TB in Renal Insufficiency 116 M/XDR-TB in Liver Disorders 117 M/XDR-TB in Seizure Disorders 117 M/XDR-TB in Substance Dependence 118 M/XDR-TB in Patients with Psychosis 118 11. Multi-drug-resistant Tuberculosis: Monitoring of Treatment and Adverse Drug Reaction 120 Pretreatment Screening and Evaluation 120 Monitoring Progress of Treatment 121 Monitoring for Adverse Effects During Treatment 122 Management of Adverse Effects 123 12. Multi-drug-resistant Tuberculosis: Case-based Approach 128 13. Multi-drug-resistant Tuberculosis: Adherence to Therapy 138 Education of Patients and their Families 138 Treatment Delivery Settings 138 Adherence to Therapy 139 Directly Observed Therapy (DOT) 139 Who can Deliver DOT for MDR-TB Patients? 139 Alternative to DOT for MDR-TB Patients 140 Maintaining Confidentiality 140 Socioeconomic Interventions 140 Social and Emotional Support 140 Follow-up of the Nonadherent Patient 141 Early and Effective Management of Adverse Drug Effects 141 14. Multi-drug-resistant Tuberculosis Contacts: Management 143 Management of Symptomatic Adult Contacts of Patients with MDR-TB 143 Management of Symptomatic Pediatric Contacts of Patients with MDR-TB 144 Chemoprophylaxis of Contacts of DR-TB Index Cases 145 15. Extensively Drug-resistant Tuberculosis: Current Status 147 Definition 147 Prevalence of XDR-TB: Global Scenario 148 Mechanisms of Resistance in XDR-TB 149 Resistance Determinants 151 Factors Responsible for XDR-TB 152 XDR-TB and HIV 152 16. Extensively Drug-resistant Tuberculosis: Diagnosis 157 Conventional Phenotypic Methods for the Diagnosis in Solid Media 157 Phenotypic Methods for the Diagnosis in liquid media 159 New Phenotypic Methods 159 Genotypic Methods 162 Genotype MTBDRplus 163 17. Extensively Drug-resistant Tuberculosis: Management 168 Management Guidelines for Patients with Documented, or Almost Certain, XDR-TB 168 Monitoring of Treatment 170 Role of Surgery 171 Human Immunodeficiency Virus (HIV) and XDR-TB 171 XDR-TB in Pediatric Patients 171 XDR-TB in Pregnancy 173 WHO Response Strategies for XDR-TB? 174 Management of Contacts of XDR-TB Patients 174 Treatment Outcome in XDR-TB 175 Control of XDR-TB 176 18. Extensively Drug-resistant Tuberculosis Failure: Management 179 Assessment of Patients at Risk for Treatment Failure 179 Indications for Suspending Treatment 180 Suspending Therapy 180 Approach to Suspending Therapy 181 Supportive Care for Patients in whom all the Possibilities of XDR-TB Treatment have Failed 181 19. Drug Resistance in Extrapulmonary Tuberculosis 183 Epidemiology 183 Diagnosis of Drug Resistance in Extrapulmonary Tuberculosis 185 Management of Drug Resistance in Extrapulmonary Tuberculosis 185 y Monitoring of Drug Resistance in Extrapulmonary Tuberculosis 185 Role of Surgery in Drug-resistant Extrapulmonary Tuberculosis 185 Treatment Success in Drug-resistant Extrapulmonary Cases 186 Problems in Management of Drug Resistance in Extrapulmonary Tuberculosis 186 Drug-resistant Central Nervous System Tuberculosis 187 Tuberculosis Drugs and their CNS Penetration 187 20. Fluoroquinolone Resistance in Tuberculosis 189 Prevalence of Fluoroquinolone Resistance 189 Mechanism of Resistance to Fluoroquinolones 190 Cross Resistance amongst Fluoroquinolones 190 Minimum Inhibitory Concentration of Fluoroquinolones 191 Early Bactericidal Activity 191 Development of Resistance During Treatment 192 Treatment Outcome in Fluoroquinolone-resistant Tuberculosis Patients 193 21. Multi-drug-resistant and Extensively Drug-resistant Tuberculosis and HIV 197 Relationship HIV and M/XDR-TB 197 Collaborative TB/HIV Activities 199 Clinical Features and Diagnosis of M/XDR-TB in HIV-infected Patients 200 Concomitant Treatment of M/XDR-TB and HIV 201 XDR-TB and HIV 207 Implications of HIV for M/XDR-TB Infection Control 207 22. Interaction between Antitubercular and Antiretroviral Drugs 211 Antiretroviral Therapy for the Treatment of HIV Infection 211 Pharmacokinetic Issues in the Treatment of HIV-related Tuberculosis 214 Interaction between Antiretroviral and Antitubercular Drugs 214 Drug-drug Interactions in the Treatment of HIV and Drug Resistant-TB (DR-TB) 216 23. Multi-drug-resistant and Extensively Drug-resistant Tuberculosis: Prevention 218 General Guidelines for the Prevention of Mdr and Xdr-TB 219 24. Drug-resistant Tuberculosis in Children 225 Epidemiology 225 Pathogenesis 226 Diagnosis of DR-TB in Children 227 Treatment of DR-TB in Children 227 Other Adjunctive Treatments 230 Treatment Duration for MDR-TB in Children 231 Xdr-Tb in Children 231 Management of Comorbid Conditions 233 Treatment Monitoring 233 25. Tuberculosis Control in India: DOTS-Plus 236 Framework 236 Case Finding Strategy 237 Enrolment into DOTS-Plus Program 238 Confirmed MDR-TB Case 238 Drug-resistant TB Center 239 Pretreatment Evaluation 240 Counseling 241 Monitoring Progress During Treatment 241 Category IV Regimen 242 Drug Dosages and Administration 243 Treatment Duration 244 Regimen for XDR-TB 244 Duration of Regimen for XDR-TB 244 Treatment Interruption and Default 245 Treatment Outcomes 246 Providing Patient and Family Counseling 246 Monitoring for Early Detection of Adverse Reactions 247 Role of DR-TB Committee in the Management of Adverse Reactions 248 Adherence 248 Follow-up of the Nonadherent Patient 248 DOTS-Plus Plan 249 26. Infection Control in Multi-drug-resistant Tuberculosis 251 Administrative Controls 251 Environmental Controls 252 Personal Respiratory Protection (Special Masks) 253 Role of Rapid Tests in Infection Control 254 27. Newer Antitubercular Drugs 255 Difficulties in Antitubercular Drug Development 255 Priorities in Developing Antitubercular Drugs 256 Methods to Develop Newer Antitubercular Drugs 256 Emerging Pipeline of New Anti-TB Drugs 256 Adjunctive Immunotherapy in MDR-TB and XDR-TB 262 Index 269


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Product Details
  • ISBN-13: 9789351522201
  • Publisher: Jaypee Brothers,medical Publishers Pvt. Ltd.
  • Publisher Imprint: Jaypee
  • Edition: 1
  • No of Pages: 495
  • ISBN-10: 9351522202
  • Publisher Date: 2015
  • Binding: Paperback
  • Height: 241 mm
  • Width: 159 mm


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