Challenges and Controversies in Defining Totally Drug-Resistant Tuberculosis

by Peter Cegielski, Paul Nunn, Ekaterina V. Kurbatova et al.
Emerg Infect Dis [Internet] November 2012

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There is no evidence that proposed totally resistant TB differs from strains encompassed by extensively drug-resistant (XDR) TB. Susceptibility tests for several drugs are poorly reproducible. Few laboratories can test all drugs, and there is no consensus list of all anti-TB drugs. Many drugs are used off-label for highly drug resistant TB, and new drugs formulated to combat resistant strains would render the proposed category obsolete. Labelling TB strains as totally drug resistant might lead providers to think infected patients are untreatable. These challenges must be addressed before defining a new category for highly drug-resistant TB.

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