When counting drugs, PZA and interferon count as zero; that is to say, when adding PZA to a four drug regimen, you must still choose another drug to make five. It is not possible to use more than one injectable (STM, capreomycin or amikacin), because the toxic effect of these drugs is additive: if possible, the aminoglycoside should be given daily for a minimum of three months (and perhaps thrice weekly thereafter). Ciprofloxacin should not be used in the treatment of tuberculosis if other fluoroquinolones are available.There is no intermittent regimen validated for use in MDR-TB, but clinical experience is that giving injectable drugs for five days a week (because there is no-one available to give the drug at weekends) does not seem to result in inferior results. Directly observed therapy certainly helps to improve outcomes in MDR-TB and should be considered an integral part of the treatment of MDR-TB.Response to treatment must be obtained by repeated sputum cultures (monthly if possible). Treatment for MDR-TB must be given for a minimum of 18 months and cannot be stopped until the patient has been culture-negative for a minimum of nine months. It is not unusual for patients with MDR-TB to be on treatment for two years or more. Patients with MDR-TB should be isolated in negative-pressure rooms, if possible. Patients with MDR-TB should not be accommodated on the same ward as immunosuppressed patients (HIV infected patients, or patients on immunosuppressive drugs).
Lusutrombopag, sold under the brand name Mulpleta among others, is a medication that has been developed for certain conditions that lead to thrombocytopenia (abnormally low platelet counts) such as thrombocytopenia associated with chronic liver disease in patients prior to elective invasive procedures. It is being manufactured and marketed in Japan by Shionogi. It was approved by the U.S. Food and Drug Administration (FDA) in July 2018, and NICE in January 2020.It was approved for medical use in the European Union in February 2019. References
External links
"Lusutrombopag". Drug Information Portal. U.S. National Library of Medicine.