Treatment of tuberculosis

Published on September 29, 2021   46 min

A selection of talks on Microbiology

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Hello everybody, welcome to this webinar session. My name is Jean-Pierre Zellweger, I am a Swiss pulmonary physician, former chief of the TB clinic at the University Hospital in Lausanne, now retired and working part-time as a consultant for the TB Competence Centre of the Swiss Lung Association in Bern, Switzerland.
I have no conflict of interest for this presentation, and as a clinician I will present the issue of TB treatment from a clinical point of view, which may sometimes be oversimplified.
The content of my presentation will speak about: the history of chemotherapy; present the current first-line drugs and mechanisms of action; some of the main second-line drugs; the standard regimens; I will address some special situations like pregnancy, children, or CNS tuberculosis; I will speak about the person-centred approach and directly observed therapy; and mention, at the end, some other options for TB treatment.
The history of chemotherapy of tuberculosis is ancient, but for some authors like Laennec, the cure of phthisis (which is tuberculosis) is possible for nature, but it's not for medicine. Laennec considered all remedies proposed for the treatment of TB as inefficient, which was actually true in 1819. For Robert Koch, after the failure of tuberculin trials, prevention and vaccination were the only prospect for a cure of TB. My predecessor at the TB dispensary in Lausanne declared - in 1940 - that, "We are not here for healing TB", but this was before the advent of chemotherapy. All attempts at the medical treatment of tuberculosis by calcium, gold salts, sulfonamides and others, failed until the discovery and use of streptomycin in 1946.