TB can be a difficult disease to treat because there are strains of TB which are resistant to drugs. There is MDR TB (Multidrug-resistant TB) and EXDR TB (Extensively drug resistant TB). Since the middle of the 20th century the strains of bacterium which cause tuberculosis have “learned” how to become resistant to many of the drugs which once were able to treat the disease.
How do TB bacteria become drug resistant?
The bacteria which cause TB behave like other bacteria. Bacteria have a remarkable instinct to survive. Bacteria are able to render medications useless in treating the diseases they cause. Sometimes bacteria become drug resistant, due to the overuse of antibiotics in the past.
Another reason that TB bacteria become drug resistant is because the individuals don’t always finish their medication, as prescribed. As with any antibiotic, many of us will stop taking antibiotics when we start to feel better. We believe that because we feel better that we must be well again. The problem with this kind of thinking is that the germs may be dying when we stop taking the drug, but when the drug fades out of the system the dying bacteria have a chance to revive and become resistant to the drug that was killing the infection.
When your doctor orders antibiotics, you are given a round that will last a certain number of days. It is important to take antibiotics until they are gone, or else the germs can become active again and become immune to the drug that you were taking.
Symptoms of MDR TB and XDR TB
The symptoms of multi-drug resistant TB include:
Weight loss
Fatigue
Weakness
Night sweats
Fever
Chest pain
Coughing
Blood in sputum
Treatment options for drug resistant TB
MDR TB – Multidrug-resistant TB is resistant to two of the strongest antibiotics used to treat TB. MDR TB can be treated, but it may take up to 2 years to get rid of the infection. The drugs used to treat MDR TB can cause severe side effects for the individual taking them. If left untreated, MDR TB can be transmitted to anyone who comes into contact with the infected person.
XDR TB – It is almost impossible to kill the bacteria that cause extensively drug-resistant TB. The strain of bacteria which cause XDR TB is resistant to 6 of the antibiotics used to treat TB. From 2004 to 2006 there were only 50 cases of XDR TB reported in the United States. The World Health Organization (WHO) says that XDR TB is very rare, but it is a worldwide threat. This form of TB is spread by droplet infection, just like other forms of TB. The people most at risk for this type of TB are those who have been around another person with XDR TB, and those who have an impaired immune system.
Conclusion
The drug resistant forms of TB are managed similarly to other forms of TB. Sputum will need to be cultured to identify the strain of the organism causing the disease. People who have MDR TB and XDR TB are treated with a combination of drugs that the organism will respond to. The medications that work for one person with drug resistant TB may not work for another person; therefore, the treatment options for people with MDR TB and XDR TB are individualized according to each person’s resistance profile. According to WHO the United States has the lowest mortality rate from tuberculosis. The statistics listed are from 2008.
Sources:
http://www.who.int/mediacentre/factsheets/fs104/en/
http://www.doh.gov.za/sa2010/healthinfo/tb.html
http://www.medicinenet.com/extensively_drug-resistant_tuberculosis_xdr_tb/page2.htm#symptoms
http://www.who.int/tb/challenges/xdr/faqs/en/index.html
