Short-term treatment of multidrug-resistant tuberculosis in this country is not recommended

Multi-drug resistant tuberculosis in Europe not treatable by short-term therapy
Infections with multidrug-resistant tuberculosis pathogens are becoming increasingly common. The treatment is "rich in side effects, expensive and above all tedious", reports the German Center for Infection Research (DZIF). Although the World Health Organization (WHO) has been recommending short-term therapy for affected patients since 2016, the DZIF scientists at the Borstel Research Center warn that such a short-term therapy in Europe is only successful in a few cases.

Multi-drug resistant tuberculosis is an increasing challenge in medicine. For example, "antibiotic-resistant strains of tuberculosis bacteria have dramatically expanded in recent decades," reports the DZIF. In some Eastern European countries, more than 40 percent of all tuberculosis cases are caused by multidrug-resistant bacterial strains (MDR-TB). The WHO recommended short-term therapy with combined use of various drugs is not helpful here, according to the latest DZIF experts' study results. Rather, individual therapeutic approaches are required.

Multidrug-resistant tuberculosis pathogens are a growing problem and so-called short-term therapy is generally unsuitable for treating European patients. (Image: Henrie / fotolia.com)

WHO recommends short-term therapy
For a long time, WHO had recommended that patients with multidrug-resistant tuberculosis (MDR-TB) be given at least four different medications daily over a 20-month period. However, studies from Bangladesh, Niger and Cameroon have recently shown that with a given combination therapy of tuberculosis drugs (initially seven different preparations in combination), only nine to twelve months of treatment would be sufficient to cure more than 80 percent of all affected patients WHO's recommendation. Since May 2016, a short-term therapy for the affected patients in all countries is recommended, as long as the bacteria are also sensitive to all treatment medications.

In Europe especially many resistant pathogens
However, according to the DZIF scientists, the WHO recommendation can not be transferred to Europe. In recent years, researchers have analyzed in more detail the spread of multidrug-resistant strains of tuberculosis bacteria in Europe, claiming that "the bacteria that spread across Europe are resistant to a particularly large number of antibiotics." In a recent study, the researchers compared now the level of antibiotic resistance of tuberculosis bacteria in more than 1,000 European MDR-TB patients.

Short-term therapy unsuitable in Europe
The analysis showed that more than 92 percent of all affected patients in Europe are not eligible for the short-term therapy, because the bacteria are already resistant to at least one of the drugs, according to the DZIF. Professor Christoph Lange, head of the study at the Research Center Borstel, emphasizes that "without a detailed knowledge of the antibiotic resistance of tuberculosis bacteria no patient in Europe should receive a short-term therapy".

Risk of developing further resistance
"If individual drugs are not effective in a therapy, this leads to a further development of antibiotic resistance," warns Professor Lange. Instead of consistent treatment, individual therapies would lead to better patient outcomes. Researchers are currently working on tailor-made therapies and developing biomarkers to individually determine the duration of treatment needed for healing, the DZIF continues. (Fp)