MDR/XDR by Dr Tasleem Arif
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overview of MDR and XDR,the present approach towards MDR/XDR management,the ppt dedicated towards those who have been suffered at the hands of TB
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MDR/XDR by Dr Tasleem Arif
- 1. MDR/XDR TB BY DR.TASLEEM ARIF DEPT. OF CHEST MEDICINE SKIMS MC/H BEMINA Srinagar, kashmir
- 20. OUTCOME OF XDR TB counted cases in US ,defined on initial DST ,1993-2007 2 1 Lost 2 1 Other 4 2 Removed from meds 9 4 Currently on RX 15 7 Moved 33 15 Died while on therapy 35 16 Completed therapy 46 Alive at DX % N
- 45. 800-1000 mg Usual adult dose is 800 mg Ofloxacin (200 mg) 1000 mg 15–20 mg/kg Capreomycin (Cm) (1 g vial) 1000 mg 15–20 mg/kg Kanamycin (1 g vial) 1000 mg 15–20 mg/kg Streptomycin (1 g vial) 2000-2500 mg 30–40 mg/kg Pyrazinamide (500 mg) 1600-2000 mg 25 mg/kg Ethambutol (400 mg) MAX DOSE (>70 KG) AVG DAILY DOSE/KG DRUG
- 46. 8 -12 g 150 mg/kg PASER ｮ (4 g sachets) 750–1000 mg 15–20 mg/kg Terizidone (250 mg) 750–1000 mg 15–20 mg/kg Cycloserine (250 mg) 750–1000 mg 15–20 mg/kg Ethionamide (Eto) (250 mg) 400 mg Usual adult dose 400 mg Moxifloxacin (Mfx) (400 mg) 750-1000 mg Usual adult dose 1000 mg Levofloxacin (250 mg, 500) Max dose(>70 Avg daily dose Drug
- 50. Special considerations for patients with renal insufficiency
- 51. 250 mg once daily, or 500 mg/dose three times per week. Yes Cycloserine 400 mg per dose three times per week (not daily) Yes Gatifloxacin 400 mg once daily No change Moxifloxacin 750-1000 mg per dose three times per week (not daily) Yes Levofloxacin 600–800 mg per dose three times per week (not daily) Yes Ofloxacin 25–35 mg/kg per dose three times per week(not daily) Yes Pyrazinamide 15–25 mg/kg per dose three times per week (not daily) Yes Ethambutol Recommended dose &frequency for patients with creatinine clearance < 30 ml/min , or for patients receiving haemodialysis Frequency Drug
- 52. 12–15 mg/kg per dose two or three times per week (not daily) caution Yes Capreomycin 12–15 mg/kg per dose two or three times per week(not daily) caution Yes Kanamycin 12–15 mg/kg per dose two or three times per week(not daily) caution Yes Streptomycin 4 g/dose, twice daily (PASER ｮ )† No change PAS 250–500 mg per dose daily No change Ethionamide NA - Terizidone Creatinine clearence <30 ml/min or pts receiving hemodialysis Frequency Drug
- 55. DOTS-plus STRATEGY