Abstract
Currently, the standard short-course chemotherapy for tuberculosis comprises a six-month regimen, with a 4-drug intensive phase and a 2-drug continuation phase. Alternative chemotherapy using more costly and toxic drugs, often for prolonged durations generally more than 18 months, is required for multidrug-resistant and extensively drug-resistant tuberculosis. Directly observed treatment, as part of a holistic care programme, is a cost-effective strategy to ensure high treatment success and curtail development of drug resistance in tuberculosis. New antituberculosis drugs are urgently needed to improve the present standard short-course chemotherapy and alternative chemotherapy, by shortening administration durations and increasing cure rates, through the greater potency of these agents. At the same time, the role of adjunctive surgery for drug-resistant tuberculosis has to be better defined. Immunotherapy might improve treatment outcomes of both drug-susceptible and drug-resistant tuberculosis, and warrants further exploration.
- ERS