Poor prerequisites for short-term treatment of multidrug-resistant tuberculosis in Europe
Daily dosis for multidrug-resistant tuberculosis patients
Multidrug-resistant tuberculosis is continuously spreading. Treatment has many side effects, is costly and, above all, lengthy. Since May 2016, the World Health Organisation (WHO) has recommended a short-term treatment regimen provided the bacteria are sensitive to all the drugs involved. However, DZIF scientists from the Research Center Borstel have warned: their studies show that such short-term treatment for patients in Europe is successful in only a minority of cases.
Over the past decades, antibiotic-resistant tuberculosis bacteria strains have spread dramatically. In some East European countries, over 40 percent of all tuberculosis cases are caused by multidrug-resistant bacterial strains (MDR-TB).
Up to now, the World Health Organisation (WHO) has recommended treating patients with MDR-TB with at least four different drugs daily over at least 20 months. However, recent studies conducted in Bangladesh, Niger and Cameroon have shown that with a specific tuberculosis drug combination treatment (starting with a regimen of seven different drugs), only nine to twelve months of treatment suffice to cure over 80 percent of the patients. Therefore, since May 2016, the WHO has recommended short-term treatment for patients in all countries provided the bacteria are actually sensitive to all the drugs involved.
Tuberculosis bacteria in Europe are particularly resistant
Does this recommendation apply to Europe as well? In the last years, DZIF scientists from the Research Center Borstel have examined the spread of multidrug-resistant tuberculosis strains more precisely, and discovered that the bacteria spreading in Europe are resistant to a particularly high number of antibiotics. They compared the levels of antibiotic resistance in tuberculosis bacteria in over 1000 MDR-TB patients in Europe.
The results show that 92 percent of the affected patients in Europe are not eligible for short-term therapy, because the bacteria are already resistant to at least one of the drugs. “Without detailed knowledge of the antibiotic resistance of the tuberculosis bacteria, no patient in Europe should receive short-term treatment,” recommends Professor Christoph Lange, head of the study at the Research Center Borstel. “Antibiotic resistance will develop further if the individual drugs in the treatment regimen are ineffective,” stresses Lange. With the support of the German Center of Infection Research, the Borstel scientists work on tailoring treatment and developing biomarkers to determine individual lengths of treatment needed to cure the disease.
