Title: Multidrug Resistant Tuberculosis (MDR TB)<br/>Author: Jon Mark Hirshon<br/><a href='http://umem.org/profiles/faculty/96/'>[Click to email author]</a><hr/><p>
        As noted previously (UMEM Pearl of 1/7/2015), <strong>tuberculosis (TB) is a major infectious disease</strong> that occurs worldwide. Strains of tuberculosis can be resistant to one or more anti-tuberculosis medications. TB strains resistant to at least one medication have been found in all surveyed countries.</p>
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        <strong>What is multidrug-resistant tuberculosis (MDR TB)?</strong></p>
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                A TB organism resistant to at least isoniazid and rifampin
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                                Two of the most common, potent and standard TB medications</li>
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                Primary cause of MDR TB is inappropriate or incorrect usage of TB medications</li>
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                In 2013, there were approximately 480,000 cases of MDR TB globally
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                                Most cases were in India, China and the Russian Federation</li>
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                A concerning form of resistant TB is extensively drug resistant TB (XDR TB), which is resistant to multiple anti-tuberculosis medications (see UMEM Pearl from 8/14/2013).</li>
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        <strong>Treatment of MDR TB</strong></p>
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                MDR TB can usually be treated and cured with second-line treatments</li>
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                Use of second-line treatments tend to be more:
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                                Difficult to access the medications</li>
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                                Expensive</li>
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                                Likely to produce severe adverse reactions</li>
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        <strong>Bottom line:</strong></p>
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        As noted previously, in your emergency department have a high index of suspicion for TB and MDR TB in patients with an appropriate risk profile.</p>
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                Recent travel from appropriate countries
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                                Most TB cases/deaths are in developing countries</li>
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                Individuals infected with HIV.</li>
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                Individuals using tobacco
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                                Increases the risk of infection and death from TB.</li>
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                Any age group, including children
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                                Mostly affects young adults in their productive years</li>
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<fieldset><legend>References</legend>

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        <a href="http://www.who.int/mediacentre/factsheets/fs104/en/">http://www.who.int/mediacentre/factsheets/fs104/en/</a></p>
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        <a href="http://www.cdc.gov/tb/topic/drtb/default.htm">http://www.cdc.gov/tb/topic/drtb/default.htm</a></p>
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        http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm</p>
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