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Drug-resistant TB ‘takes longer to cure, poses more risk’

SINGAPORE — Compared with patients diagnosed with tuberculosis (TB), those infected with the multi-drug-resistant strain of the disease will have to take more medicines a day, and the types of medication they consume also put them at risk of side effects such as kidney, liver or psychiatric problems.

Drug-resistant TB ‘takes longer to cure, poses more risk’

Tuberculosis x-ray. TODAY file photo

SINGAPORE — Compared with patients diagnosed with tuberculosis (TB), those infected with the multi-drug-resistant strain of the disease will have to take more medicines a day, and the types of medication they consume also put them at risk of side effects such as kidney, liver or psychiatric problems.

Doctors TODAY spoke to also noted that patients diagnosed with such multi-drug-resistant strains will take more time to be completely cured. The doctors were commenting after the Ministry of Health (MOH) said on Wednesday that there was an unusual cluster of six multi-drug resistant TB cases at a public housing block on Ang Mo Kio Avenue 3.

The inappropriate treatment of TB and patients’ poor adherence to the treatment increases the likelihood that drug-resistant strains will develop. The use of antibiotics has also led to the rise of such strains 
of the disease.

But these strains remain in the minority: Of the 1,498 new TB cases among Singapore residents, less than 1 per cent were multi-drug-resistant.

Dr Ong Kian Chung, a respiratory specialist at Mount Elizabeth Hospital, said that while a normal TB patient will have to take three to four types of medication each day, those with drug-resistant strain of TB will have to take more, about four to six types of medication each day.

He added that the treatment for patients diagnosed with the drug-resistant strain also varies widely, depending on the number of drugs the patient is resistant to and the patient’s tolerance for certain types of medication.

These patients tend to experience more side effects as they are taking second- or third-line medication, which are “less tolerable” and could result in kidney, liver, neurological or psychiatric problems.

The full treatment for normal TB patients takes about six to nine months, while those with the multi-drug-resistant strains will need between 20 to 24 months to recover, noted the MOH on Wednesday. With a longer treatment period, there is a higher chance of developing complications during the process, 
added Dr Ong.

Dr Leong Hoe Nam, an infectious disease specialist at Mount Elizabeth Novena Specialist Centre, said those with TB and the multi-drug-resistant strain will no longer become infectious after two weeks of treatment. On the effectiveness of BCG vaccinations, he noted that they may only work against two rare forms of TB — TB in the brain and in the blood.

To date, there are no effective vaccinations against TB in the lungs, added Dr Leong. 

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