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Journal Article > Short Report

Precision medicine for drug-resistant tuberculosis in high-burden countries: is individualised treatment desirable and feasible?

Cox HS, Hughes J, Black JM, Nicol MP
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Abstract
Treatment for drug-resistant tuberculosis is largely delivered through standardised, empirical combination regimens in low-resource, high-burden settings. However, individualised treatment, guided by detailed drug susceptibility testing, probably results in improved individual outcomes and is the standard of care in well-resourced settings. Driven by the urgent need to scale up treatment provision, new tuberculosis drugs, incorporated into standardised regimens, are being tested. Although standardised regimens are expected to improve access to treatment in high-burden settings, they are also likely to contribute to the emergence of resistance, even with good clinical management. We argue that a balance is required between the need to improve treatment access and the imperative to minimise resistance amplification and provide the highest standard of care, through a precision medicine approach. In tuberculosis, as in other diseases, we should aim to reduce the entrenched inequalities that manifest as different standards of care in different settings.
Subject Area
tuberculosis
DOI
10.1016/S1473-3099(18)30104-X
Published Date
13-Mar-2018
PubMed ID
29548923
Languages
English
Journal
Lancet Infectious Diseases
Volume / Issue / Pages
Volume 18, Issue 9
Issue Date
01-Sep-2018
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