A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management
Mohammed Alfaqeeh,1,2 Prayudi Santoso,3 Jan-Willem Alffenaar,4,5 Ivan S Pradipta2,6,7 1Doctoral Program of Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 2Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia;...
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Dove Medical Press
2025-06-01
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| author | Alfaqeeh M Santoso P Alffenaar JW Pradipta IS |
| author_facet | Alfaqeeh M Santoso P Alffenaar JW Pradipta IS |
| author_sort | Alfaqeeh M |
| collection | DOAJ |
| description | Mohammed Alfaqeeh,1,2 Prayudi Santoso,3 Jan-Willem Alffenaar,4,5 Ivan S Pradipta2,6,7 1Doctoral Program of Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 2Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 3Division of Respirology and Critical Care, Department of Internal Medicine Dr. Hasan Sadikin General Hospital /Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 4School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; 5Sydney Infectious Diseases Institute, University of Sydney, Sydney, Australia; 6Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia; 7Indonesian Tuberculosis Research Network/Jetset TB, Jakarta, IndonesiaCorrespondence: Ivan S Pradipta, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia, Tel +62 22 84288888 ext. 3510, Email ivanpradipta@unpad.ac.idAbstract: Drug-resistant tuberculosis (DR-TB) continues to be a major global health threat, and while advancements in drug therapies have been made, the role of pharmacists in improving patient outcomes has not been fully optimized. This review aims to describe the types, resistance mechanisms, and management strategies of DR-TB, with a focus on discussing the critical role of pharmacists in optimizing treatment outcomes for DR-TB patients. A narrative review approach was adopted to provide an updated and evidence-based perspective. Additionally, manual review of reference lists from the retrieved articles was performed to identify additional relevant studies. The review identifies types of DR-TB, including mono-, poly-, rifampicin-, multi-, pre-extensively, and extensively-drug resistance. Resistance mechanisms are outlined, highlighting mutations in key genes, such as those involved in rifampicin and isoniazid (INH) resistance, which compromise treatment efficacy. The treatment regimens for DR-TB include the INH-R regimen, Bedaquiline, Pretomanid, and Linezolid (with or without Moxifloxacin) (BPaL(M) regimen, shorter oral regimen, and longer oral regimen, each tailored to the specific resistance pattern and patient condition. The challenges in managing DR-TB include complex treatment regimens and side effects, social barriers such as stigma and adherence issues, and system-related obstacles like limited resources and healthcare infrastructure. The review underscores pharmacists’ vital yet underutilized role in addressing challenges. Pharmacists’ contributions include patient counseling to improve adherence, and optimizing regimens for vulnerable populations and therapeutic drug monitoring. Addressing DR-TB requires a multifaceted approach, with pharmacists playing a critical role in its management. Their contributions are key to improving patient outcomes and overcoming the challenges associated with DR-TB management.Keywords: pharmacists, drug-resistant, tuberculosis, medication management, adherence, therapeutic drug monitoring |
| format | Article |
| id | doaj-art-49686276cf574a7db0a7d23233dbb260 |
| institution | DOAJ |
| issn | 1178-2390 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Multidisciplinary Healthcare |
| spelling | doaj-art-49686276cf574a7db0a7d23233dbb2602025-08-20T03:24:01ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902025-06-01Volume 18Issue 135313544103977A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis ManagementAlfaqeeh M0Santoso P1Alffenaar JW2Pradipta IS3Department of Pharmacology and Clinical PharmacyInternal MedicineFaculty of Medicine and Health, School of PharmacyDepartment of Pharmacology and Clinical Pharmacy, Faculty of PharmacyMohammed Alfaqeeh,1,2 Prayudi Santoso,3 Jan-Willem Alffenaar,4,5 Ivan S Pradipta2,6,7 1Doctoral Program of Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 2Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 3Division of Respirology and Critical Care, Department of Internal Medicine Dr. Hasan Sadikin General Hospital /Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 4School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; 5Sydney Infectious Diseases Institute, University of Sydney, Sydney, Australia; 6Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia; 7Indonesian Tuberculosis Research Network/Jetset TB, Jakarta, IndonesiaCorrespondence: Ivan S Pradipta, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia, Tel +62 22 84288888 ext. 3510, Email ivanpradipta@unpad.ac.idAbstract: Drug-resistant tuberculosis (DR-TB) continues to be a major global health threat, and while advancements in drug therapies have been made, the role of pharmacists in improving patient outcomes has not been fully optimized. This review aims to describe the types, resistance mechanisms, and management strategies of DR-TB, with a focus on discussing the critical role of pharmacists in optimizing treatment outcomes for DR-TB patients. A narrative review approach was adopted to provide an updated and evidence-based perspective. Additionally, manual review of reference lists from the retrieved articles was performed to identify additional relevant studies. The review identifies types of DR-TB, including mono-, poly-, rifampicin-, multi-, pre-extensively, and extensively-drug resistance. Resistance mechanisms are outlined, highlighting mutations in key genes, such as those involved in rifampicin and isoniazid (INH) resistance, which compromise treatment efficacy. The treatment regimens for DR-TB include the INH-R regimen, Bedaquiline, Pretomanid, and Linezolid (with or without Moxifloxacin) (BPaL(M) regimen, shorter oral regimen, and longer oral regimen, each tailored to the specific resistance pattern and patient condition. The challenges in managing DR-TB include complex treatment regimens and side effects, social barriers such as stigma and adherence issues, and system-related obstacles like limited resources and healthcare infrastructure. The review underscores pharmacists’ vital yet underutilized role in addressing challenges. Pharmacists’ contributions include patient counseling to improve adherence, and optimizing regimens for vulnerable populations and therapeutic drug monitoring. Addressing DR-TB requires a multifaceted approach, with pharmacists playing a critical role in its management. Their contributions are key to improving patient outcomes and overcoming the challenges associated with DR-TB management.Keywords: pharmacists, drug-resistant, tuberculosis, medication management, adherence, therapeutic drug monitoringhttps://www.dovepress.com/a-call-to-action-empowering-pharmacists-in-drug-resistant-tuberculosis-peer-reviewed-fulltext-article-JMDHpharmacistsdrug-resistanttuberculosismedication managementadherencetherapeutic drug monitoring |
| spellingShingle | Alfaqeeh M Santoso P Alffenaar JW Pradipta IS A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management Journal of Multidisciplinary Healthcare pharmacists drug-resistant tuberculosis medication management adherence therapeutic drug monitoring |
| title | A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management |
| title_full | A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management |
| title_fullStr | A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management |
| title_full_unstemmed | A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management |
| title_short | A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management |
| title_sort | call to action empowering pharmacists in drug resistant tuberculosis management |
| topic | pharmacists drug-resistant tuberculosis medication management adherence therapeutic drug monitoring |
| url | https://www.dovepress.com/a-call-to-action-empowering-pharmacists-in-drug-resistant-tuberculosis-peer-reviewed-fulltext-article-JMDH |
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