TREATMENT OF MULTIDRUG-RESISTANT PULMONARY TUBERCULOSIS AND OPTIMIZATION OF TREATMENT EFFICACY

• Yitmasova T.D

  Bukhara State Medical Institute named after Abu Ali ibn Sino, Bukhara, Uzbekistan

  Author

Multidrug-resistant tuberculosis (MDR-TB) remains a critical global health challenge, necessitating the development of novel strategies to optimize treatment outcomes. Morphological characteristics of the lungs in patients with MDR-TB provide crucial insights into disease progression and therapeutic responses. Among the various adjunctive therapeutic approaches, thiotriazoline, a thiol-containing compound, has emerged as a promising candidate in enhancing the efficacy of treatment regimens. This article reviews the morphological alterations associated with MDR-TB and explores the role of thiotriazoline in pathogenetic therapy, highlighting its potential in optimizing treatment efficacy.

World Health Organization. (2023). Global Tuberculosis Report 2023. WHO. Retrieved from https://www.who.int/tb/publications/global_report/en/

Udwadia, Z. F., Amale, R. A., Ajbani, K. K., & Rodrigues, C. (2012). Totally drug-resistant tuberculosis in India. Clinical Infectious Diseases, 54(4), 579–581.

Dheda, K., Gumbo, T., Maartens, G., Dooley, K. E., McNerney, R., Murray, M., ... & Warren, R. M. (2017). The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis. The Lancet Respiratory Medicine, 5(4), 291–360.

Lange, C., Chesov, D., Heyckendorf, J., Leung, C. C., Udwadia, Z., & Dheda, K. (2018). Drug-resistant tuberculosis: An update on disease burden, diagnosis, and treatment. Respirology, 23(7), 656–673. https://doi.org/10.1111/resp.13304

Pontali, E., Raviglione, M. C., & Migliori, G. B. (2019). Regimens to treat multidrug-resistant tuberculosis: past, present, and future perspectives. European Respiratory Review, 28(152), 190035. https://doi.org/10.1183/16000617.0035-2019

Gandhi, N. R., Nunn, P., Dheda, K., Schaaf, H. S., Zignol, M., van Soolingen, D., & Bayona, J. (2018). Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. The Lancet, 391(10131), 1642–1656. https://doi.org/10.1016/S0140-6736(18)30139-3

Jenkins, H. E., Tolman, A. W., Yuen, C. M., Parr, J. B., Keshavjee, S., Pérez-Vélez, C. M., ... & Cohen, T. (2014). Incidence of multidrug-resistant tuberculosis disease in children: systematic review and global estimates. The Lancet, 383(9928), 1572–1579. https://doi.org/10.1016/S0140-6736(14)60195-1

Jassal, M., & Bishai, W. R. (2010). Extensively drug-resistant tuberculosis. The Lancet Infectious Diseases, 10(3), 159–170. https://doi.org/10.1016/S1473-3099(09)70330-3

World Health Organization. (2021). WHO Consolidated Guidelines on Tuberculosis. Module 4: Treatment - Drug-Resistant Tuberculosis Treatment. WHO. Retrieved from https://www.who.int/publications/i/item/9789240028173

Tiberi, S., du Plessis, N., Walzl, G., Vjecha, M. J., Rao, M., Ntoumi, F., ... & Migliori, G. B. (2022). Tuberculosis: progress and advances in development of new drugs, treatment regimens, and host-directed therapies. The Lancet Infectious Diseases, 22(3), e191–e206.

https://doi.org/10.1016/S1473-3099(21)00457-3

Conradie, F., Diacon, A. H., Ngubane, N., Howell, P., Everitt, D., Crook, A. M., ... & Nunn, A. J. (2020). Treatment of highly drug-resistant pulmonary tuberculosis. New England Journal of Medicine, 382(10), 893–902.

https://doi.org/10.1056/NEJMoa1901814

Migliori, G. B., Tiberi, S., Zumla, A., Petersen, E., Chakaya, J. M., Wejse, C., & Duarte, R. (2020). MDR/XDR-TB management of patients and contacts: challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network. International Journal of Infectious Diseases, 92S, S15–S25.

https://doi.org/10.1016/j.ijid.2020.01.042

World Health Organization. (2023). Global Tuberculosis Report 2023. Geneva: WHO.

https://www.who.int/publications/i/item/9789240077560

Ahmad, N., Ahuja, S. D., Akkerman, O. W., Alffenaar, J. W. C., Anderson, L. F., Baghaei, P., ... & Zignol, M. (2018). Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. The Lancet, 392(10150), 821–834.

https://doi.org/10.1016/S0140-6736(18)31644-1

Furin, J., Cox, H., & Pai, M. (2019). Tuberculosis. The Lancet, 393(10181), 1642–1656.

https://doi.org/10.1016/S0140-6736(19)30308-3

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