Extensively drug-resistant tuberculosis (XDR-TB) is a global problem and represents a serious challenge for public health and clinical management. Laboratory diagnosis is difficult and little evidence exists to guide clinicians in treating people with XDR-TB effectively. To summarize the available data on XDR-TB, we performed a review on 12 recent studies focusing on the epidemiology and clinical management of XDR-TB. Methods. Studies that met inclusion criteria were reviewed to assess methodology, treatment regimens, and treatment outcomes. Results. XDR-TB can be successfully treated in up to 65% of patients, particularly those who are not co-infected with HIV. However, treatment duration is longer and outcomes are in general poorer than for non-XDR-TB patients. Conclusion. Future studies should fulfil the following criteria: i) be prospective in design, ii) adopt standardized, internationally accepted definitions, iii) use quality-assured laboratory testing for all first- and second-line drugs, and iv) collect data on an agreed-upon set of standard variables allowing for comparisons across studies. Early diagnosis and aggressive management of XDR-TB increase the chance of a positive outcome, although prevention is still a key objective of any national TB programme.
|Translated title of the contribution||The XDR-TB emergency: Answers from the scientific community|
|Number of pages||6|
|Journal||Rassegna di Patologia dell'Apparato Respiratorio|
|Publication status||Published - Oct 2009|
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Pulmonary and Respiratory Medicine