What is Drug-Resistant Tuberculosis and How is it Managed?

What is Tuberculosis (TB)?

Tuberculosis (TB) is a severe bacterial disease that remains a global health challenge. According to data collected by the World Health Organization (WHO), tuberculosis killed more than 1.3 million people globally in 2022, and more than 10 million people contracted the disease last year alone.

A few facts about tuberculosis:

• Tuberculosis is the second leading infectious killer after COVID-19
• Tuberculosis causes more deaths annually than HIV and AIDS
• Tuberculosis is treatable, curable, and preventable
• But drug-resistant TB remains a public health crisis

Fortunately, dedicated healthcare providers like those at Lynn Community Health Center (LCHC) provide a reliable, comprehensive support system for infectious diseases like tuberculosis.

Our medical experts help you understand drug-resistant TB and how it’s different from traditional tuberculosis. This article examines its impact, management, and the crucial role health centers play to combat the disease.

Understanding Tuberculosis

Your average tuberculosis is caused by the mycobacterium tuberculosis bacterium. It’s a contagious disease that primarily affects the lungs, but TB can spread to other parts of the body.

Typically, the disease is transmitted through air droplets from an infected person, and a tuberculosis diagnosis is determined through a blood test, skin test, chest x-ray, and other lab tests.  If you suspect you may have been exposed to TB, it’s important to seek medical attention.

Symptoms associated with tuberculosis include:

• A persistent cough with bloody phlegm
• Severe chest pain
• Generalized fatigue and weakness
• Unintended weight loss
• Loss of appetite
• Fever, night sweats, and chills

If the disease isn’t treated, it can cause complications like lung damage, meningitis (if it spreads to the brain), damage to joints, and impaired liver or kidney function. If left untreated, it can be deadly.

With appropriate medical treatment, though, tuberculosis is curable. Lynn Community Health Center offers dedicated tuberculosis outpatient services in conjunction with the Massachusetts Department of Public Health.

Treatment for Tuberculosis

Tuberculosis treatment typically involves a combination of several drugs, including isoniazid and rifampin. However, in cases of drug-resistant tuberculosis, alternative medications and more intensive treatment plans may be needed. A person’s specific prescription and dosage depend on the progression of the disease and the type of TB they have.

Common tuberculosis treatment drugs include: 

• Isoniazid
• Rifampin (Rimactane)
• Rifabutin (Mycobutin)
• Rifapentine (Priftin)
• Pyrazinamide
• Ethambutol (Myambutol)

Many disease sufferers recover after a full course of treatment—with the prescribed drugs killing the bacteria and preventing new bacteria from forming—but some TB is what medical experts call drug-resistant.

Why Drug-Resistant Tuberculosis is An Emerging Challenge

Drug-resistant TB occurs when the bacteria develop resistance to the efficacy of standard anti-tuberculosis drugs. According to CDC data, approximately 8% of cases in 2022 were reported to be resistant to the most potent tuberculosis treatment drug, isoniazid. More than 1% were multidrug-resistant.

It’s not just multidrug resistance that makes drug-resistant TB so challenging. It’s also access to quality care. The same WHO research cited above also showed that only about 2 in 5 people with drug-resistant TB got any kind of treatment in 2022.

The Challenges of Managing Drug-Resistant Tuberculosis

Drug-resistant tuberculosis poses significant challenges because conventional tuberculosis treatments, like isoniazid and rifampin, are less effective at killing the bacteria. This means people with drug-resistant TB need longer and more complex treatment regimens, often involving second-line antibiotics.

Drug-resistant TB challenges include:

• An increased physical and psychological toll – Lengthy and intensive treatment regimens often come with severe side effects.
• Greater economic and social impact – Treatment costs are higher, and the disease impacts a patient’s ability to work and socialize.
• A stronger public health concern – The spread of drug-resistant strains of TB in the community and the difficulties in managing outbreaks increase as treatment is prolonged.

Treatment Options for Drug-Resistant Tuberculosis

Although challenging, drug-resistant TB isn’t necessarily a lifelong disease. But it does require careful, expert management.

Treatment for drug-resistant tuberculosis often involves a more complex and longer drug regimen than standard TB treatment. Customized treatment plans are based on drug-susceptibility testing and can also include second-line antibiotics like fluoroquinolones and other injectables.

Treatment typically lasts 18-24 months (or longer) and demands close monitoring for effectiveness and side effects. Supportive care—including nutritional and psychological support—is important, and adherence to the treatment regimen is essential.

Directly Observed Therapy (DOT) from a qualified healthcare provider measures success and helps prevent further resistance development.

How Community Health Centers Help Manage Drug-Resistant Tuberculosis

Health centers like Lynn play a crucial role in managing drug-resistant TB, especially in areas where treatment options are scarce.

Health centers do the following:

• Develop and maintain TB prevention, control, and elimination policies.
• Maintain a system for timely surveillance analysis of TB cases.
• Provide medical consultations, treatments, and social services tailored to the community’s needs.
• Coordinate with private-sector practitioners to ensure seamless care.

Prevention and Control: Lynn’s Community-Focused Approach

Lynn Community Health Center does not conduct tuberculosis screenings, but we do provide services to those who have already tested positive.

We advocate for prevention strategies like vaccination, public education, early detection, and treatment adherence. Our healthcare programs and services play a vital role in these efforts, especially as we educate and support at-risk populations in the area. If you’re concerned about your risk of TB, or have questions about drug-resistant tuberculosis, contact us today.

We believe that ongoing support for affected individuals is essential to manage tuberculosis in our community. Reach out to our medical experts today to learn more about drug-resistant TB and what we’re doing to treat it.