Drug and therapeutics bulletin
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Resistance to drugs used to treat tuberculosis (TB) is a major public health problem that threatens progress made in TB management and control worldwide. It may result from improper use of antibiotics, including prescription of non-standard treatment regimens and poor adherence to drug therapy. ⋯ In 2012, DTB discussed the investigation, management and treatment of patients with MDR- and XDR-TB. Earlier this year, ▼bedaquiline (Sirturo) and ▼delamanid (Deltyba) were authorised by the European Medicines Agency (EMA) under its 'conditional market authorisation' scheme for use as part of an appropriate combination regimen for pulmonary MDR-TB in adult patients "when an effective treatment regimen cannot otherwise be composed for reasons of resistance or tolerability." In this article, we review the evidence for bedaquiline in the management of MDR-TB.
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Smoking causes around 100,000 deaths each year in the UK, and is the leading cause of preventable disease and early mortality. Smoking cessation remains difficult and existing licensed treatments have limited success. ⋯ However, the increase in the use of e-cigarettes and their potential use as an aid to smoking cessation has been subject to much debate. In this article we consider the regulatory and safety issues associated with the use of e-cigarettes, and their efficacy in smoking cessation and reduction.