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Second line drug susceptibility testing to inform the treatment of rifampin-resistant tuberculosis: a quantitative perspective
- Source :
- International Journal of Infectious Diseases, Vol 56, Iss C, Pp 185-189 (2017)
- Publication Year :
- 2017
- Publisher :
- Elsevier, 2017.
-
Abstract
- Treatment failure and resistance amplification are common among patients with rifampin-resistant tuberculosis (TB). Drug susceptibility testing (DST) for second-line drugs is recommended for these patients, but logistical difficulties have impeded widespread implementation of second-line DST in many settings. To provide a quantitative perspective on the decision to scale up second-line DST, we synthesize literature on the prevalence of second-line drug resistance, the expected clinical and epidemiologic benefits of using second-line DST to ensure that patients with rifampin-resistant TB receive effective regimens, and the costs of implementing (or not implementing) second-line DST for all individuals diagnosed with rifampin-resistant TB. We conclude that, in most settings, second-line DST could substantially improve treatment outcomes for patients with rifampin-resistant TB, reduce transmission of drug-resistant TB, prevent amplification of drug resistance, and be affordable or even cost-saving. Given the large investment made in each patient treated for rifampin-resistant TB, these payoffs would come at relatively small incremental cost. These anticipated benefits likely justify addressing the real challenges faced in implementing second-line DST in most high-burden settings.
Details
- Language :
- English
- ISSN :
- 12019712 and 18783511
- Volume :
- 56
- Issue :
- C
- Database :
- Directory of Open Access Journals
- Journal :
- International Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.0ec4917bc760421da7ae68f0d1125dac
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.ijid.2016.12.010