Talking medicine Why drug adherence is key in TB treatment

I recently read about a new drug active against TB that was undergoing trials in South Africa. The drug is called Bedaquiline. It was approved by the FDA in the United States.
Tuberculosis (TB) often attacks people whose immunity has been impaired that is the HIV positive, people on corticosteroids, those on anticancer drugs, the stressed among others. This however does not mean that anyone falling outside this group is not at risk.
TB is curable and the earlier one gets treastment, the better. The treatment of TB is divided into two phases according to World Health Organisation (WHO) guidelines. The first stage involves taking about four types of drugs for two months. True, these tablets are not ordinary size and they come with side effects, some scary, like reddening of one’s urine, but these are all explained in counselling and the benefit outweighs the risks.
The second phase involves treatment with a minimum of two types of drugs as deemed fit by one’s doctor. This phase often goes up to four to six months.
The topic of adherence is very important when it comes to TB. The treatment explained above is described as firstline. And firstline treatment often considers how effective the drug is, the ease of use, availability, safety and cost among other factors. Failure on firstline means one being moved to second line which may not have all the above factors favourable.
However, there are increasing cases of drug resistance when it comes to TB. Germs are clever one can say, they too follow the law of natural selection which is survival for the fittest. They therefore if exposed to under-dose or insufficient doses of a drug find ways of resisting its effects. When this goes on for some time, the germs become resistant to originally efficient doses of the medicine. This spells trouble whether for that particular patient or the people who pick the infection from them.
For TB, we now have strains called Multi-Drug Resistant and Extensively Drug Resistant TB and quite clearly, this is trouble. So taking one’s medicine when they are supposed to take it and how they are supposed to take it for the recommended time is very important.

The writer is a pharmacist

SOURCE: Daily Monitor


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