Penanganan Tuberkulosis Resistan Obat pada Daerah Terpencil: Mission Impossible?

Ivan Banjuradja, Asep Purnama

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Background: Complicated drug-resistant Tuberculosis (TB) management becomes a distinctive challenge for health care provider in rural area. Case: We reported 6 drug-resistant TB cases that were found in Sikka Regency, East Nusa Tenggara, based on rapid molecular test. Each case had unique problem which needs specific management, such as difference between the conventional and rapid drug susceptibility test, appearance of second line injection drug resistant (Pre-XDR TB), Human Immunodeficiency Virus (HIV) co-infection, emergence of serious acute psychosis side effect, and the drop out management. Discussion: We will discuss the management of each individual’s problem that arises during the antitubercular treatment monitoring and the requiring regimen modification under the national guideline. Conclusion: Drug-resistant TB management is a very complex matter. However, with sustainable effort, commitment, and collaboration between referral center and health care provider in rural area, guidelin be appropriate management could be achieved. Despite its possibility, prevention of resistant TB should have been done as early as possible, one of them is completion of regular TB treatment.


Drug resistant Tuberculosis, Rural area, Regimen modification

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Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Pedoman Nasional Pengendalian Tuberkulosis 2014. Jakarta.

Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Petunjuk Teknis Manajemen Terpadu Pengendalian Tuberkulosis Resistan Obat 2014. Jakarta.

Bhardwaj P, Deshkar AM, Verma R., Side Effects Encountered in Treatment of Multidrug-resistant Tuberculosis: A 3-Year Experience at First Dots Plus Site of Chhattisgarh. International Journal of Scientific Study. August 2015; 3 (5):104–7.

Lomtadze N, Aspindzelashvili R, Janjgava M, Mirtskhulava V, Wright A, Blumberg HM, Prevalence and Risk Factors for MultidrugResistant Tuberculosis in Republic of Georgia: A Population Based Study. Int J Tuberc Lung Dis. January 2009; 13(1): 68–73.

He XC, Zhang XX, Zhao Jn, Liu Y, Yu CB, Yang GR, et al. Epidemiological Trends of Drug-Resistant Tuberculosis in China from 2007 to 2014. Medicine (Baltimore). April 2016; 95(15): e3336.

Bhatt G, Vyas S, Trivedil K. An Epidemiological Study of Multi Drug Resistant Tuberculosis.Indian J Tuberc. January 2012;59(1):18-27.

Gomes M, Correia A, Mendonça D, Duarte. Risk Factors for Drug Resistant Tuberculosis. Journal of Tuberculosis Research, 2014;(2); 111–18.

García S, Blanco AR, Pérez JLV, Viejo MAG, Hernández MJ J, López O, et al. Risk factors for multidrug-resistant tuberculosis in a tuberculosis unit in Madrid, Spain. Eur J Clin Microbiol Infect Dis. April 2009;28(4): 325–30.

Da Silva PEA, Palomino JC. Molecular basis and mechanisms of drug resistance in Mycobacterium tuberculosis: classical and new drugs. Journal of Antimicrobial Chemoteraphy. May 2011;66(7); 1417–30.

Suchindran S, Brouwer ES, Van Rie A. Is HIV Infection a Risk Factor for Multi-Drug Resistant Tuberculosis? A Systematic Review. PLoS ONE. May 2009; 4(5): e556.

World Health Organization. Companion Handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis. Geneva, Switzerland: WHO; 2014, 1–446.

Archibald C. Cohen. Pyridoxine in the Prevention and Treatment of Convulsions and Neurotoxicity due to Cycloserine. Ann N Y Acad Sci. 1969 Sep 30;166(1): 346–9.

Singhal P, Dixit P, Singh P, Jaiswal I, Singh M, Jain A. A study on pre-XDR & XDR tuberculosis & their prevalent genotypes in clinical isolates of Mycobacterium tuberculosis in north India. Indian J Med Res. 2016 Mar;143(3): 341–7.

Zaki SA. Adverse Drug Reaction and Casualty Assessment Scale. Lung India. June 2011;28(2): 152–3.

Wood JD, Peesker SJ, Gorecki DK, Tsui D. Effect ofl-Cycloserine on brain GABA metabolism. Can J Physiol Pharmacol. February 1978; 56(1): 62–8.

Rouaud E, Billard JM. D-Cycloserine facilitates synaptic plasticity but impairs glutamatergic neurotransmission in rat hippocampal slices. Br J Pharmacalol. November 2003; 140(6): 1051–6.

Jacobs TQ, Ross A. Adverse effects profile of multidrug-resistant tuberculosis treatment in a South African outpatient clinic. S Afr Farm Pract. 2012;54(6): 531–9.


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