Abstract
The first anti-tuberculosis drug streptomycin was created in 1945. Before this time the therapy for TB was based on diet and fresh air. Un-controlled using of antibiotics provoked development of drug resistant strains, so the history of urogenital TB can be divided into three periods: before antibiotics (AB), AB era and novo-days – MDR period. Mtb is drug-resistance, which may be: mono – Mtb are resistant to one of any antituberculous drugs; poly – Mtb are resistant to more than one of any drugs used for the treatment of the disease, excluding isoniazid and rifampicin simultaneously; multi-drug resistance (MDR) – Mtb are resistant to at least isoniazid and rifampicin, with or without resistance to other first-line drugs. Extensively drug-resistant TB (XDR-TB) refers to resistance to at least isoniazid and rifampicin, and to any fluoroquinolone, and to any of the three second-line injectables (amikacin, capreomycin and kanamycin). Persistence excluded an old specific for UGTB symptom – aseptic pyuria. Mtb hurts tissue and fades in persistence – for example, because the patient takes drugs for “UTI”. Damaged tissues are rapidly colonized by E.Coli – and now co-morbidity of UGTB and non-specific UTI enriches 75 %.
WHO notes that five drugs are currently regarded as essential in the management of TB – isoniazid, rifampicin, pyrazinamide, streptomycin and ethambutol. Thioacetaxone is also widely used to supplement isoniazid in many developing countries because of its low cost. Other drugs, including para-aminosalicylic acid (PAS), kanamycin, cycloserine, capreomycin, viomycin and ethionamide, can be of value in treating patients with MDR, but, in general, are more expensive and more toxic.
Possibilities of chemotherapy may be limited by different side effects. Usually a patient with TB has at least one more disease, and co-morbidity demands to take into account potential drug interaction, which may lead both to increasing and decreasing therapeutic effect.
Keywords
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Kulchavenya, E. (2016). Chemotherapy for Urogenital Tuberculosis. In: Current Therapy and Surgery for Urogenital Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-319-28290-9_4
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