Multi-drug-resistant TB Treatment Guidelines
--------------------------------------------
A few days ago Dr J Rawlinson from South Africa reported that the
guidelines for treating Multi-drug-resistant (MDR) Tuberculosis in
South Africa were available on request. I suggested to him that plac-
ing these guidelines on the Web would be a useful service. This has
now been done by Dr Tony D'Emanuele on the Pharmweb site. The URL is:
http://www.pharmweb.net/pwmirror/library/tbres/drugres1.pdf
This file requires Adobe Acrobat reader to view or print the file.
For those of you without Web access you can contact Dr Rawlinson di-
rectly for the file:
mailto:RawlinsonJ@nphw.nt.healthlink.org.za
I found the publication very interesting as it reflects the reality
of treating this difficult condition. They emphasize the importance
of preventing MDR TB through DOTS with Fixed Dose Combination ther-
apy. The guidelines describe two approaches to deciding what drug
therapy to use, a standardized approach and a customized approach.
The guidelines strongly recommend the standardized approach. I can
understand that under program conditions this may be the most practi-
cal, but under ideal conditions I wonder if an individualised regimen
would not be the best option. I would welcome the comments of experts
in both developed and developing worlds on this issue. As DOTS PLUS
programs begin to be planned how should regimens be chosen?
Richard Laing
mailto:richardl@bu.edu
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