Un desafío farmacológico del siglo xxi: Tuberculosis multidrogoresistente

Abstract

Introduction: Tuberculosis is an infectious disease, within the main causes of mortality that occupies the tenth place worldwide. It is important to consider that in immunosuppressed patients such as those suffering from acquired immunodeficiency syndrome (AIDS) there is a higher risk of developing multidrug resistance, being the main obstacle to treatment, therefore, the review of the subject will allow us to have treatment alternatives to reduce morbidity and mortality and costs in care and social productivity. Objective: To carry out a bibliographic review on multidrug-resistant tuberculosis, which allows health sciences personnel to obtain new knowledge about this disease that constitutes a pharmacological challenge today. Methodology: An exhaustive search for information was carried out in articles related to the topic of multi-resistance to tuberculosis treatment, based on the criteria of patients with treatment failure, positive sputum culture, after four months of therapy, patients with relapse recurrent after apparent recovery, patients with active tuberculosis resistant to first and second line antifungals, patients residing in or traveling to an area with a high prevalence of resistant tuberculosis. In addition, the articles were originally updated from the last five years in the database: scopus, up date, extracting relevant information. Results and discussion: After an extensive search for information, it was found that multidrugresistant tuberculosis, especially to isoniazid and rifampicin, implies adherence to new drugs, and is considered a great threat to global public health, due to the fact that it implies high costs, adverse effects due to its toxicity, duration of prolonged treatment, among others. Therefore, treatment should focus on both curing the individual patient and minimizing transmission of Mycobacterium tuberculosis to others. In this way, these drugs provide us with the capacity for management that helps reduce morbidity and mortality in patients with risk factors, thus obtaining a basis for tuberculosis control. Conclusion: It is concluded that the work carried out shows that tuberculosis has remained a notable global health problem, that although the COVID-19 pandemic has slowed down the progress made in the last decade for its control, it should continue. promoting strategies that, hand in hand with the availability of technological advances, allow an early and timely diagnosis in people already infected who have not responded to first-choice antifungals, especially in patients who had HIV, who according to statistics have a higher mortality, in order to administer a new therapy, in addition to avoiding the reintroduction of multidrug-resistant tuberculosis from countries with a higher rate of resistance. As there is no possibility of discovering a 100% effective vaccine, or the discovery of new antimicrobial associations that cure TB in a short time, new drugs are incorporated that, although they involve greater spending on the state, less efficacy, many of these with great adverse effects and longer duration of treatment open up a great challenge for the current management of this disease where prevention x contributes a lot to continue on the path towards its eradication