CLASSIFYING NEW ANTI-TUBERCULOSIS DRUGS AND MANAGEMENT OF ITS ADR AS PER WHO: A SHORT REVIEW

Abstract

The classification of new anti-tuberculosis (TB) drugs from World Health Organization (WHO) is important as it helps to aware and know current Newly introduced anti-TB Drugs for clinician and health workers to build an appropriate anti-TB regimen for drug susceptible (DS), multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB cases that do not fulfill the criteria for the shorter MDR-TB regimen. The World Health Organization (WHO) has recently approved a revision of the classification of new anti-TB drugs based on current evidence on each drug. In the previous WHO guidelines, the choice of drugs was based on efficacy and toxicity in a step-down manner, from group 1 first-line drugs and groups 2–5 second-line drugs, to group 5 drugs with potentially limited efficacy or limited clinical evidence. In the revised WHO classification, exclusively aimed at managing drug-resistant cases, medicines are again listed in hierarchical order from group A to group D. Treatment of drug susceptible tuberculosis (DS-TB) requires regimens containing first line drugs (FLDs’) whereas drug resistant tuberculosis (DR-TB) are treated with regimens comprising combination of both second line drugs (SLDs’) and few FLDs’. Adverse drug reactions (ADRs’) to these anti-tubercular drugs are quite common as they are being used for longer duration. The occurrence of ADRs’ may be influenced by multiple factors and may range from mild gastrointestinal disturbances to serious hepatotoxicity, ototoxicity, nephrotoxicity peripheral neuropathy, cutaneous ADRs’, etc. Most of ADRs’ are minor and can be managed without discontinuation of treatment. Some ADRs’ can be major or severe causing life-threatening experience leading to either modification or discontinuation of regimen and even mortality if not recognized and treated promptly.