WellSpan Home

Multidrug-Resistant Tuberculosis (TB)

Topic Overview

Multidrug-resistant tuberculosis (MDR-TB) occurs when the bacteria are resistant to at least isoniazid and rifampin. This means that these medicines are unable to kill the bacteria. The reasons antibiotic resistance occurs include:

  • Medicine treatment failure. Failure to complete the entire course of treatment is the major cause of multidrug-resistant TB. If all of the medicines prescribed are not taken as directed, the weaker bacteria are killed, but some stronger, more resistant bacteria survive. These resistant bacteria can grow and cause TB disease that is difficult to cure.
  • Inadequate TB control measures. People with multidrug-resistant TB disease can infect others with drug-resistant bacteria. This has happened in prisons, hospitals, and homeless shelters.

People who have resistant disease are at increased risk for dying of TB, especially if they also are infected with the human immunodeficiency virus (HIV). People who are at highest risk for developing multidrug-resistant TB are those who:

  • Have a weakened immune system, such as people who are infected with HIV, have AIDS, or have cancer.
  • Have been in close contact with a person who is infected with multidrug-resistant TB.
  • Do not take their prescribed medicine regularly or do not take all of their medicine.
  • Develop TB disease again after having taken TB medicine in the past.
  • Come from areas where TB is common, such as Southeast Asia, Africa, or Latin America.

To reduce the problem of drug resistance, doctors now use the following guidelines to treat all people who have resistant TB:footnote 1

  • Almost everyone begins treatment of TB with four different medicines, which are taken until a culture test shows no bacteria. Then, two medicines are taken for 4 to 7 months. Young children and pregnant women may begin TB treatment using only three medicines.
  • Everyone who has TB is tested to learn which medicines will kill the TB-causing bacteria (antibiotic sensitivity testing).
  • A health professional must watch the person take every dose of medicine. This is called directly observed therapy (DOT) and may mean a daily office or home visit. DOT does help make sure that all of the medicines are taken, and it has raised cure rates.
  • Whenever possible, a person is treated at a center that specializes in treating multidrug-resistant TB.

A rare type of MDR-TB is called extensively drug-resistant tuberculosis (XDR-TB). This type of TB is resistant to isoniazid, rifampin, and several other medicines used to treat TB. And some TB bacteria have become resistant to all of the antibiotics commonly used to treat TB. This is sometimes called totally resistant tuberculosis (TDR-TB).footnote 2

Related Information

References

Citations

  1. American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America (2003). Treatment of tuberculosis. American Journal of Respiratory and Critical Care Medicine, 167(4): 603-662.
  2. Cegielski P, et al. (2012). Challenges and controversies in defining totally drug-resistant tuberculosis. Emerging Infectious Diseases [Internet], November. Available online: http://wwwnc.cdc.gov/eid/article/18/11/12-0526_article.htm.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerR. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care Medicine, Medical Toxicology
W. David Colby IV, MSc, MD, FRCPC - Infectious Disease

Current as ofNovember 18, 2017


Are you sure you would like to cancel?

All information will be lost.

Yes No ×

About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.

×

Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to https://my.wellspan.org, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.

×