Management der antibiotikaresistenten Tuberkulose

Die Verbreitung multiresistenter Tuberkulosebakterien erschwert die Kontrolle der Tuberkulose vor allem in der WHO-Region Europa. Seit 2022 gibt es dank neuer Medikamente aktualisierte Empfehlungen, um die Dauer der Therapie deutlich zu reduzieren. In diesem Beitrag werden neben der Epidemiologie und Diagnostik der antibiotikaresistenten Tuberkulose auch aktuelle Therapieempfehlungen vorgestellt.

Abstract

The spread of multidrug-resistant Mycobacterium tuberculosis bacteria jeopardizes tuberculosis control, especially in the WHO Europe region. Following the availability of novel drugs and treatment regimens the World Health Organization has updated management recommendations for patients affected by drug-resistant tuberculosis. These novel recommendations include a significant reduction in the duration of therapy. This review presents the epidemiology and diagnostics of antibiotic-resistant tuberculosis as well as up-to-date treatment recommendations.

Kernaussagen

• Noch nie waren so viele Menschen auf der Welt gleichzeitig von einer Tuberkulose betroffen wie heute.

• Basierend auf der Evidenz der Wirksamkeit von Zweitlinienmedikamenten hat die WHO die Definitionen für die antibiotikaresistente Tuberkulose neu festgelegt.

• Die Standardtherapie der MDR/RR-TB mit BPaL (M) dauert nur noch 6 Monate.

• Aktuell befinden sich 17 neue Medikamente in den Phasen I und II der klinischen Entwicklung.

• Es bestehen erhebliche Probleme in der Implementierung einer neuen Diagnostik und Therapie in Hochinzidenzländern.

Schlüsselwörter

multiresistente Tuberkulose - extensiv-resistente Tuberlulose - Bedaquilin - Pretomanid

Keywords

multidrug-resistant tuberculosis - extensively drug-resistant tuberculosis - bedaquiline - pretomanid

Publication History

Article published online:
15 September 2023

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