Extensively drug-resistant tuberculosis

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Extensively drug-resistant tuberculosis
Synonyms	XDR-TB
Pronounce	N/A
Specialty	N/A
Symptoms	Cough, fever, weight loss, night sweats
Complications	Respiratory failure, death
Onset	Gradual
Duration	Chronic
Types	N/A
Causes	Mycobacterium tuberculosis resistant to isoniazid, rifampicin, any fluoroquinolone, and at least one of the three second-line injectable drugs (amikacin, kanamycin, or capreomycin)
Risks	HIV/AIDS, previous tuberculosis treatment, contact with XDR-TB patients
Diagnosis	Sputum culture, drug susceptibility testing
Differential diagnosis	Multidrug-resistant tuberculosis, tuberculosis
Prevention	Infection control, vaccination, contact tracing
Treatment	Second-line anti-tuberculosis drugs, bedaquiline, linezolid
Medication	N/A
Prognosis	Poorer than multidrug-resistant tuberculosis
Frequency	Rare compared to tuberculosis
Deaths	High mortality rate

Extensively drug-resistant tuberculosis (XDR-TB) is a form of tuberculosis that is resistant to at least four of the core anti-TB drugs. XDR-TB arises when drug-resistant TB does not receive proper treatment, leading to further resistance.

Definition

The World Health Organization (WHO) defines XDR-TB as TB that is resistant to isoniazid and rifampicin, the two most powerful anti-TB drugs, as well as any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin).

Epidemiology

XDR-TB has been identified in 117 countries worldwide. The highest rates are found in Eastern Europe and Central Asia. In 2019, there were an estimated 484,000 new cases of multidrug-resistant TB (MDR-TB) and XDR-TB.

Treatment

Treatment for XDR-TB is lengthy, expensive, and has many side effects. The drugs used are not as effective as the first-line drugs for TB, and patients often need to take them for up to two years. In addition, patients often need extensive support and monitoring to help them adhere to treatment.

Prevention

Preventing the spread of XDR-TB involves improving the detection and treatment of drug-resistant TB. This includes strengthening TB control programs, ensuring access to quality-assured TB drugs, and improving infection control in healthcare settings.

See also

• Multidrug-resistant tuberculosis
• Tuberculosis management
• Tuberculosis treatment