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Printable Handouts
Navigable Slide Index
- Introduction
- Dekkerswald
- History of TB in Holland
- Overview
- Management of TB before era of drug treatment
- Sunhouses in the garden
- Surgery for TB
- Drug treatment was introduced from 1943-1963
- Rifampicin (1963)
- For 40 years no new drugs were introduced
- Timeline: discovery of drugs for TB
- TB incidence increased again
- TB case notifications in Tanzania
- TB case notifications in Malawi
- Definitions
- Emergence of totally drug resistant TB
- Epidemiology
- Notified MDR-TB cases, 2011 (absolute)
- Notified MDR-TB cases, 2011 (per population)
- Proportion of MDR among new TB cases, 2011
- MDR among previously treated TB cases, 2011
- Estimated MDR-TB cases, 2007
- Outcomes of MDR-TB treatment
- Reports of at least one XDR-TB case by 2012
- XDR-TB outbreak in South Africa
- Survival curve of HIV patients with XDR TB
- Current drug treatment
- MDR and XDR TB can be cured
- Treatment outcome in several cohorts
- Death rates in several cohorts
- Current approach for treatment of MDR/XDR TB
- Programmatic or individualized approach
- After diagnosis with rapid molecular diagnostics
- Classical division of anti-tuberculosis drugs
- WHO's programmatic management of DR TB
- Anti-TB agents referred to in guidelines
- Treatment recommendations
- Treatment recommendations (duration)
- Group 1: oral first-line agents
- INH may be used in higher dosages in MDR TB
- Recommendations for rifabutin
- Group 2: fluoroquinolones (1)
- Group 2: fluoroquinolones (2)
- Group 3: injectables (1)
- Group 3: injectables (2)
- Group 4: less-effective anti-TB drugs
- Group 5: less-effective or clinical data sparse drugs
- Changes to the guidelines (2011)
- Future drug treatment
- New compounds
- TB drug development pipeline
- Budget needed for 2008-2015
- Current portfolio of the GATB
- Global TB drug pipeline
- Novel compounds to treat active TB disease
- Bedaquiline (TMC207)
- FDA approved bedaquiline (Sirturo) for MDR TB
- The nitroimidazoles
- EMA approved Deltyba, 2013
- PA-824
- SQ 109 (Sequella)
- Oxazolidinones: inhibit protein synthesis
- The quinolones: in phase III
- Phase II trials presented in Paris, Oct 2013
- Thioridazine
- TB treatment with thioridazine
- Global Alliance: trials & new combinations (NC)
- NC-001 (PA-824, moxifloxacine, PZA)
- Dreams and realities for the future of TB treatment
- Thank you
Topics Covered
- Management of multi drug resistance (MDR) and extensive drug resistance (XDR) TB
- Management of TB before era of drug treatment
- Surgery for TB
- Drug treatment was introduced from 1943-1963
- Rifampicin (1963)
- Timeline: discovery of drugs for TB
- Emergence of totally drug resistant TB – Epidemiology
- Outcomes of MDR-TB treatment
- Survival curve of HIV patients with XDR TB
- Current drug treatment
- Treatment outcome in several cohorts
- Death rates in several cohorts
- Current approach for treatment of MDR/XDR TB
- WHO's programmatic management of DR TB
- Treatment recommendations
- Group 1: oral first-line agents
- Group 2: fluoroquinolones
- Group 3: injectables
- Group 4: less-effective anti-TB drugs
- Group 5: less-effective or clinical data sparse drugs
- Future drug treatment
- New compounds
- Bedaquiline (TMC207)
- The nitroimidazoles – Thioridazine
- NC-001 (PA-824, moxifloxacine, PZA)
- Dreams and realities for the future of TB treatment
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Boeree, M. (2014, May 12). Management of MDR and XDR TB [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 3, 2024, from https://doi.org/10.69645/PMQR4598.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Martin Boeree has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Management of MDR and XDR TB
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Martin Boeree.
I'm an associate professor in
respiratory medicine at the Radboud
University Nijmegan Medical
Center and at the TB
Referral Hospital Dekkerswald
in Nijmegen, the Netherlands.
I'm going to talk
about the management
of multi-drug
resistant and extensive
drug resistant tuberculosis.
0:21
I'm working in Dekkerswald.
Dekkerswald is an old
tuberculosis sanatorium
which was raised in 1911.
0:31
Sanitoria were a tradition
deriving from the time
before the drugs
against tuberculosis.
In Holland, they were divided
by religious background.
And you can clearly see this on
the facade with the Catholic cross.
0:46
This slide shows an
outline of my presentation.
I will talk about management of
multi-drug resistant and extensive
drug resistant tuberculosis.
I will start with an
introduction, then briefly talk
about the epidemiology of
multi-drug resistant tuberculosis,
and then continue with management.
I will specifically go
into the drug treatment,
both current treatment
and future treatment.
I will now start with
the introduction.
1:14
Management of tuberculosis
before the era of drug treatment
was done in specially
dedicated sanitoria.
The first one opened
in 1855 in Gorbersdorf
in Germany in the current
Poland called Sokolowsko.
It contained rest, a good
diet, a regular day and night
rhythm, and healthy air and sunlight.
It was done with love,
tender, and care.
Sometimes surgery like
artificial pneumothorax
was performed to give
rest to the lung.