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The challenge of managing extensively drug-resistant tuberculosis at a referral hospital in the state of São Paulo, Brazil: a report of three cases

Authors :
Marcos Abdo Arbex
Hélio Ribeiro de Siqueira
Lia D'Ambrosio
Giovanni Battista Migliori
Source :
Jornal Brasileiro de Pneumologia, Vol 41, Iss 6, Pp 554-559 (2015)
Publication Year :
2015
Publisher :
Sociedade Brasileira de Pneumologia e Tisiologia, 2015.

Abstract

ABSTRACT Here, we report the cases of three patients diagnosed with extensively drug-resistant tuberculosis and admitted to a referral hospital in the state of São Paulo, Brazil, showing the clinical and radiological evolution, as well as laboratory test results, over a one-year period. Treatment was based on the World Health Organization guidelines, with the inclusion of a new proposal for the use of a combination of antituberculosis drugs (imipenem and linezolid). In the cases studied, we show the challenge of creating an acceptable, effective treatment regimen including drugs that are more toxic, are more expensive, and are administered for longer periods. We also show that treatment costs are significantly higher for such patients, which could have an impact on health care systems, even after hospital discharge. We highlight the fact that in extreme cases, such as those reported here, hospitalization at a referral center seems to be the most effective strategy for providing appropriate treatment and increasing the chance of cure. In conclusion, health professionals and governments must make every effort to prevent cases of multidrug-resistant and extensively drug-resistant tuberculosis.

Details

Language :
English, Portuguese
ISSN :
18063756
Volume :
41
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Jornal Brasileiro de Pneumologia
Publication Type :
Academic Journal
Accession number :
edsdoj.3b98da5ac38b436bb3f337ae8e12fffd
Document Type :
article
Full Text :
https://doi.org/10.1590/S1806-37562015000000299