E-drug: MDR TB Treatment Guidelines (cont)
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A few days ago Dr J Rawlinson from South Africa reported that the
guidelines for treating MDR TB in South Africa were available on request. I
suggested to him that placing 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 directly
at RawlinsonJ@nphw.nt.healthlink.org.za for the file.
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 therapy. 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 practical, but under ideal conditions I
wonder if an individualized 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
Associate Professor
Department of International Health
Boston University School of Public Health
715 Albany St
Boston MA 02118-2526
E-mail richardl@bu.edu
Tel 617 414-1444
Fax 617 638-4476
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