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

Hdl Handle:
http://hdl.handle.net/10144/619094
Title:
Precision medicine for drug-resistant tuberculosis in high-burden countries: is individualised treatment desirable and feasible?
Authors:
Cox, H; Hughes, J; Black, J; Nicol, MP
Journal:
The Lancet. Infectious Diseases
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.
Publisher:
Elsevier
Issue Date:
13-Mar-2018
URI:
http://hdl.handle.net/10144/619094
DOI:
10.1016/S1473-3099(18)30104-X
PubMed ID:
29548923
Submitted date:
2018-04-17
Language:
en
ISSN:
1474-4457
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorCox, Hen
dc.contributor.authorHughes, Jen
dc.contributor.authorBlack, Jen
dc.contributor.authorNicol, MPen
dc.date.accessioned2018-04-17T16:38:43Z-
dc.date.available2018-04-17T16:38:43Z-
dc.date.issued2018-03-13-
dc.date.submitted2018-04-17-
dc.identifier.citationPrecision medicine for drug-resistant tuberculosis in high-burden countries: is individualised treatment desirable and feasible? 2018 Lancet Infect Disen
dc.identifier.issn1474-4457-
dc.identifier.pmid29548923-
dc.identifier.doi10.1016/S1473-3099(18)30104-X-
dc.identifier.urihttp://hdl.handle.net/10144/619094-
dc.description.abstractTreatment 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.en
dc.language.isoenen
dc.publisherElsevieren
dc.rightsArchived with thanks to The Lancet. Infectious Diseasesen
dc.titlePrecision medicine for drug-resistant tuberculosis in high-burden countries: is individualised treatment desirable and feasible?en
dc.identifier.journalThe Lancet. Infectious Diseasesen

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