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Guidance call for new TB drugs

Friday March 24th, 2017

New antibiotics could help stem the spread of multi-drug resistant TB - but clinicians need clear guidelines on their use to ensure they remain effective, experts say today in a report marking World TB Day.

Clinicians need accurate diagnostic tests, clear prescription guidelines and improved efforts to prevent transmission, according to the report in The Lancet Respiratory Medicine.

About 5% of TB cases are multi-drug resistant or extensively-drug resistant (XDR), the experts say.

About half the cases of multi-drug resistance in 2015 were found in India, China and Russia, they say. Patients with the problem have a 40% mortality rate.

They report that a small number of repurposed and new drugs are now available.

Professor Keertan Dheda, of the University of Cape Town, South Africa, leader of a commission on the subject, said: "Cure rates for drug resistant TB are poor and people can remain infectious and at risk of spreading the disease.

"Improved diagnostic tests are on the horizon, but we need huge efforts to increase their accuracy, use them for active case finding in the community, and eventually make them available in low income countries so as to inform treatment decisions and preserve the efficacy of any new antibiotic drugs for TB."

Fellow expert Dr Zarir Udwadia, from Hinduja Hospital & Research Centre, Mumbai, India, said: "Despite some small scale programmes for compassionate use of new life-saving drugs such as bedaquiline and delamanid, there is no widespread access in India meaning these drugs remain unavailable to patients who need them most.

"Many patients at risk of transmission, or who need palliative care, live in the community because hospitals are full. In addition to new drugs, we need to ensure that patients with incurable disease are treated with dignity and afforded the care they need."

Dheda et al. The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis The Lancet Respiratory Medicine 24 March 2017 [abstract]

Tags: Africa | Pharmaceuticals | Respiratory | World Health

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