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Inicio Medicina Clínica (English Edition) Update on the treatment of tuberculosis
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Vol. 163. Issue 5.
Pages 245-252 (September 2024)
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Vol. 163. Issue 5.
Pages 245-252 (September 2024)
Review
Update on the treatment of tuberculosis
Actualización sobre el tratamiento de la tuberculosis
Joan Martínez-Campreciósa,b,1, Juan Espinosa-Pereiroa,c,1,
Corresponding author
juan.espinosa@vallhebron.cat

Corresponding author.
, Adrián Sánchez-Montalváa,b,c,1
a Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, Universitat Autónoma de Barcelona, Programa de Salud Internacional del Instituto Catalán de la Salud (PROSICS), Barcelona, Spain
b Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
c Grupo de Estudio de Infecciones por Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
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Abstract
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Tables (2)
Table 1. Summary of regimens, drugs and doses.
Table 2. Risk factors for treatment failure and relapse in tuberculosis.
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Abstract

Tuberculosis (TB) affects more than 10 million people each year. We have contested this burden with a paradoxically slow development of treatments, as compared to other infectious diseases. This review aims to update health care professionals on the last developments for the management of TB. The combination of drugs established more than 40 years ago is still adequate to cure most people affected by TB. However, with the generalisation of regimens based on rifampicin and isoniazid for (only) 6 months, resistance emerged. Resistant cases needed long tratments based on injectable drugs. Now, after an exciting decade of research, we can treat resistant TB with oral regimens based on bedaquiline, nitroimidazoles, and linezolid for (only) 6 months, and we may soon break the 6-month barrier for treatment duration. However, these improvements are not enough to end TB without an engagement of people affected and their communities to achieve adherence to treatment, transmission control, and improve socioeconomic determinants of health.

Keywords:
Mycobacterium tuberculosis
Drug resistance
Global management
Short treatment
Bedaquiline
Resumen

La tuberculosis (TB) afecta a más de 10 millones de personas cada año. Hemos respondido a esta carga con un desarrollo de tratamientos paradójicamente lento, en comparación con otras enfermedades infecciosas. Los tratamientos basados en rifampicina e isoniazida durante (sólo) 6 meses, establecidos hace más de 40 años, permiten curar a la mayoría de las personas afectadas por la tuberculosis. La generalización de estos tratamientos llevó a la selección y de resistencias, requiriendo tratamientos prolongados basados en medicamentos inyectables. Desde hace poco podemos tratar la tuberculosis resistente con regímenes orales basados bedaquilina, nitroimidazoles y linezolid durante (sólo) seis meses, y estamos empezando a romper la barrera de los seis meses de duración del tratamiento. Estas mejoras no son suficientes para poner fin a la tuberculosis sin la participación de las personas afectadas para lograr la adherencia al tratamiento, el control de la transmisión y mejorar los determinantes socioeconómicos de la salud.

Palabras clave:
Mycobacterium tuberculosis
Farmacorresistencia
Manejo multidisciplinar
Tratamiento corto
Bedaquilina

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